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, don't have health insurance at work or maybe it just costs too much. Whatever the reason, CHIP may be able to help. All families need to to 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. Not true! CHIP has expanded to cover uninsured kids and teens up to age 19 who are not eligible for Medical Assistance. Back to top


What's the cost for CHIP coverage?
For most families, it's free. Families with incomes above the free CHIP limits will pay low monthly premiums and co-pays for some services. Click here to see the income chart.

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Who offers CHIP insurance coverage?
CHIP is administered 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 every year in order for the coverage to continue. CHIP insurance companies send renewal notices 90 days before their benefits are going to end, and families must fill out and send the renewal information back to their CHIP insurance company in order for 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 can apply for CHIP.

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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. You are still required to renew your CHIP and MA benefits as you do now.

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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 to determine whether your child is eligible for CHIP or Medical Assistance. Under the Affordable Care Act, beginning Jan. 1, 2014, CHIP must use a different method of determining eligibility than it previously used. This new method is 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 calimed as a tax dependent on next year's tax return, this step-child/sibling will be inlcuded 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? Maybe it's 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.