Children's Health Insurance Program (CHIP) - Healthpocket

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What is CHIP?

The Children's Health Insurance Program (CHIP) is the component of the Medicaid program that provides low-cost or free health insurance to children. Currently over 7 million children up to age 19 are enrolled in CHIP. CHIP programs are administered local state governments. Some states have different names for their CHIP program but the required services are the same in every state. When the program was launched in 1997, it was known as the State Children’s Health Insurance Program (SCHIP) but later became known as simply CHIP.

Many CHIP programs charge a monthly premium for its health insurance coverage. Routine check-ups are free but other services may require a copayment. CHIP costs are capped at 5% of an enrollee’s monthly family income.

Who qualifies for CHIP?

As is the case for the Medicaid program, eligibility requirements for CHIP vary from state to state. Eligibility requirements include U.S. citizenship or qualified resident aliens. Children in families with annual incomes up to $45,000 (for a family of four) typically are eligible for the program. Pregnant women may also qualify for coverage in most states.

By using our Medicaid & Public Plans Tool, you can find contact information for your local CHIP program.

What are CHIP benefits?

States have considerable discretion with respect to the benefits they include within their CHIP coverage. However, every state is required to provide the below services at a minimum:

  • Routine check-ups
  • Immunizations
  • Dental care
  • Vision care
  • Inpatient and outpatient hospital care
  • Laboratory services
  • X-ray services

Other services are provided on a state-by-state basis. Pregnant women may be entitled to labor and delivery costs and 60 days of post-delivery care.

Routine and “well child” appointments are free in every state, but co-pays vary for other services. Some states charge a monthly fee for coverage which is capped at 5% of your monthly income.

How do I enroll?

The application process varies by state and may include in-person, online, phone and mail options. To find out more about your state’s program, including eligibility requirements, pricing, and coverage options, call 1-877 KIDS NOW (1-877-543-7669).

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