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CHIP (Children's Health Insurance Program)

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CHIP (sometimes referred to as State Children’s Health Insurance Program or S-CHIP) is a partnership between the federal government and states. CHIP provides health insurance for targeted children under age 19, who do not qualify for Medicaid. The idea is to provide health coverage for children in families that earn too much to qualify for Medicaid, but not enough to afford private health insurance.

All states have a CHIP plan.  Each state sets its own rules for eligibility within the federal guidelines. CHIP allows coverage for children of families earning up to 200% of the Federal Poverty Level or 50% higher than the state had previously covered under Medicaid.

States either deliver CHIP as an expansion of Medicaid, through a state designed or private program, or a combination of the two.

Some states have obtained waivers to also cover adults.

All CHIP programs cover:

  • Inpatient (in hospital) care
  • Outpatient care
  • Emergency care
  • Many kinds of specialist care
  • Most states cover mental health care and substance abuse services

States may use managed care plans to deliver CHIP.

To learn more about CHIP in your state, including eligibility requirements, how to apply, and coverage, visit: www.insurekidsnow.gov offsite link. Click on Lean About Programs In Your State.

NOTE:

  • If emergency care is needed, all emergency rooms must treat emergency situations without regard to ability to pay.
  • When seeking medical care for children, also see the resources described in: Uninsured: How To Obtain The Medical Care You Need
  • Also keep in mind that all federally funded hospitals must provide a certain amount of free or low cost care because of the Hill-Burton Act. For information, including questions to ask, click here. In addition, there may be funds available from private donations to pay for care. Ask the finance department of the hospitals in your local or nearby areas.

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