FAQ: What is the CHIP Program?

What is the CHIP program?
CHIP, is short for the Children's Health Insurance Program, Pennsylvania’s program to provide health insurance to uninsured children and teens who are not eligible for or enrolled in Medical Assistance. There are a lot of reasons kids might not have health insurance - maybe their parents lost a job, or their parents are not offered health insurance at work, or maybe it just costs too much. Whatever the reason, CHIP may be able to help. All families need to do is apply today.

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I thought CHIP was only for low-income families?
Parents may think their kids can't get CHIP because they make too much money but this is simply not true. CHIP has expanded its coverage to all uninsured kids and teens up to age 19 who are not eligible for Medical Assistance.

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What's the cost for CHIP coverage?
Many families can qualify for free coverage. For those families with incomes above the free CHIP limits there are reduced and full cost coverages that allow families to pay low monthly premiums and low co-payments for most services. Click here to see the income guidelines for CHIP eligibility.

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Who offers CHIP insurance coverage?
CHIP coverage is provided by private health insurance companies that are licensed and regulated by the Pennsylvania Insurance Department and have contracts with the commonwealth to offer CHIP coverage. To find out who offers CHIP in your county, please click here.

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How long is my child covered once they are enrolled in CHIP?Once enrolled, children are guaranteed 12 months of CHIP coverage unless they no longer meet the basic eligibility requirements. Families must renew their coverage each year in order for their child’s CHIP coverage to continue. CHIP insurance companies where the child is enrolled, will send renewal notices 90 days before the benefits are scheduled to end.  The families must fill out and send the renewal information back to their CHIP insurance provider in order for CHIP benefits to continue.

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I recently gained legal custody of my grandchildren. They are uninsured and need health benefits. Can I apply for CHIP for them?
Yes! As the legal guardian who is exercising care and control of the children, you may apply for CHIP benefits for the children.

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My child has a pre-existing condition. Will that affect our eligibility?
There are no exclusions for pre-existing conditions in CHIP or Medical Assistance. However, if your child has a serious medical condition or disability, he or she may be considered for Medical Assistance.

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Does CHIP have a waiting list?
No. There is no waiting list to enroll in CHIP.

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Will CHIP still exist with the implementation of the Affordable Care Act (ACA)? Will I lose my CHIP coverage and be forced to have another kind of insurance?
The CHIP program (as well as Medical Assistance/Medicaid) is still in place. Please continue to renew your CHIP and MA benefits each time you receive your renewal notices.

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How will CHIP determine if my child is eligible for the program?
CHIP will use the information you provide in your CHIP application, as well as other state and federal databases, to determine whether your child is eligible for CHIP coverage or Medical Assistance. Under the Affordable Care Act, which went into effect on January 1, 2014, CHIP uses calculations based on federal income tax rules with some modifications to determine household income.

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My child has a stepparent. Will the stepparent's income be counted when we apply for CHIP?
Under the Affordable Care Act, a parent is defined as a biological, adoptive or stepparent. This means that a stepparent's income must be counted in the eligibility determination. If a step-sibling is living in the household or is expected to be claimed as a tax dependent on next year's tax return, this step-child/sibling will be included in the eligibility determination as well.

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I have more questions. What should I do?
Couldn't find the answer you're looking for in these questions and answers? Perhaps your answer is located under another category in our FAQ section. Check it out.

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FREQUENTLY ASKED QUESTIONS

For questions about coverage and benefits, contact a CHIP health insurance company.

To find health insurance companies that offer CHIP in your area search by county.