Health Insurance 101: What Is CHIP?

CHIP comes through to cover your kids’ healthcare needs when you don’t qualify for Medicaid.

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Most private insurance plans provide coverage for dependents, like children. When you add more dependents to a family plan, the premium (monthly fee) generally goes up. What happens if families can’t afford this higher premium taken out of their monthly pay, but they don’t quite qualify for Medicare or Medicaid? Luckily, CHIP may help provide health insurance for children in these families.

What Is the Children’s Health Insurance Program, or CHIP?

CHIP stands for Children’s Health Insurance Program, which provides free or low-cost insurance for kids 18 and under. In particular, the program helps children whose parents’ income isn’t low enough to qualify for government-subsidized insurance, but they cannot afford to buy into other plans that would cover their growing family. In some states, pregnant women are also able to enroll in CHIP for herself and unborn baby.

The purpose of CHIP is to ensure that all kids have access to health care during the times they need it most. Research shows that health status during childhood can affect an individual for the rest of their life. Poor health during childhood (and in utero) increases the risk of poor health during adulthood.

These adult diseases not only affect the individual’s life, but add up to a higher burden on society, the economy, and the healthcare system. In other words, government-subsidized insurance for children is an investment in the present and future of the country.

What Does This Program Cover?

CHIP is a federal program, but is managed by each state’s Medicaid administrator. Every state offers CHIP, but the specifics can vary in different locations.

In general, CHIP covers the following for enrolled children:

  • Annual routine physicals
  • Sick visits
  • Prescription medications
  • Hospital care
  • Emergency services
  • X-ray and lab tests
  • Vaccinations
  • Vision and dental

A Factor That Affects Eligibility: Location, Location, Location

Each state has different terms to qualify (but the average eligible household income is up to $106,000). You can inquire and apply any time of year, as there are no enrollment limits. Visit HealthCare.gov or InsureKidsNow.gov to apply for CHIP or call 1-800-318-2596 to see if you’re eligible in your state.