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CHIP, short for the Children's Health Insurance Program, is 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, their parents are not offered health insurance at work, or maybe other options cost too much. Whatever the reason, CHIP may be able to help. All families need to do is apply
Parents may think their kids can't get CHIP because they make too much money, but this is not true. CHIP has expanded its coverage to all uninsured kids and teens up to age 19 who are not eligible for Medical Assistance
Many families can qualify for free coverage. For 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. See the income guidelines for CHIP eligibility
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. Find out who offers CHIP in your county
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 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.
As the legal guardian who is exercising care and control you can apply for healthcare for your grandchild(ren). Your grandchild(ren) that live with you due to legal adoption may be eligilble for CHIP. When you apply for CHIP, your income will only be counted if you have legally adopted your grandchild(ren).
There are no exclusions for pre-existing conditions in CHIP or Medical Assistance
. If your child has a serious medical condition or disability, he or she may be considered for Medical Assistance.
No. There is no waiting list to enroll in CHIP.
CHIP (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.
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.
Under the Affordable Care Act, a parent is defined as a biological, adoptive, or step-parent. This means that a step-parent'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.