Learn About the Children’s Health Insurance Program

The Children’s Health Insurance Program is commonly called “CHIP”. It is a program designed to provide health coverage to eligible children either through the Medicaid or through separate CHIP programs in certain states.

Certain states also allow for pregnant women to obtain health coverage. CHIP is a joint state and federal program as it is administered by the states, although it must follow specific federal requirements.

CHIP has specific eligibility requirements that must be met in order for assistance to be granted. Applicants must meet the income limits, residency requirements and more in order to enroll. An application form must be completed and supporting documentation must be provided in order to be considered.

To learn more about the application process and the CHIP eligibility requirements, read the sections below.

Discover CHIP Requirements

Before you start the application process for the program, it is important that you understand what the eligibility requirements are. Each state has CHIP requirements that you must meet to qualify.

Although each state sets some of its own criteria for determining eligibility, there are basic federal requirements that must be met as well. A few of the most common requirements include the following:

Age

The CHIP program caters to low-income families with dependent children. Therefore, you must have at least one child who is 18 years of age or younger to apply. However, some states also offer health coverage through CHIP to pregnant women, regardless of their age.

If you do not have any minor dependent children in your household, or you are not pregnant, you do not qualify for CHIP.

Residency

In order to qualify for CHIP, you must be able to provide proof of legal presence in the United States. You must be either a U.S. citizen or an eligible non-citizen. Eligible non-citizens include legal permanent residents, refugees and victims of trafficking. There may be additional groups of qualified non-citizens as well, depending on the state.

Note: Certain non-citizens must wait five years after receiving legal status in the United States before applying for CHIP coverage in some states. However, there are exceptions to this rule. For instance, in California children do not need to wait five years before receiving coverage.

Income

Every state publishes the annual and/or monthly income limits to qualify for CHIP on a yearly basis. The income limits are determined based on family size and other factors.

Because the program is designed to help low-income families with children to receive necessary health coverage, the income of the household is one of the biggest factors when determining eligibility. Only families with incomes at or below the limits set in place by the state qualify.

Find Out How to Apply for the CHIP Program

After you determine whether you are eligible for the Children’s Health Insurance Program in your state, you can begin the application process. Keep in mind that each state has its own application process. Some states allow you to complete an application online through their own website.

Regardless of the method you use to apply, you must ensure that you provide detailed information regarding your household size, income, employment, disability status and more when filling out the application form.

It is beneficial to have certain documentation on hand when you complete the application so that you can answer all questions accurately. A few of the documents you will need include:

  • Employment and income documents – Pay stubs, tax return documents, etc.
  • Proof of identity documents – A passport, U.S. driver’s license, etc.
  • Proof of legal status – Legal permanent resident card, certificate of naturalization, etc.

When you provide this information, you must ensure that you are providing details regarding each member in your household. Ensure that you have all of the necessary documents on hand in order to adequately provide information regarding dates of birth, Social Security numbers, employment status and more.  

Discover Where to Apply for CHIP

Depending on your state, there may be different methods available that can be used to apply for CHIP.

Some states, such as Connecticut, Kansas and Idaho, provide their own state CHIP program and allow applicants to apply through their online portals. To do so, you must visit the website and complete the application electronically. You may need to create an account with the website before your application can be submitted.

However, there are some states such as North Dakota and Maine that do not have online applications available. In these situations, you must submit an application through an alternative method such as in person, by mail or over the phone. It is essential that you check what your state’s application methods are before applying so that you are completely prepared.

What Should I Expect After I Apply?

Regardless of the method, you used to submit your application, you will need to wait for some time after you submit your application before you are notified about your status. CHIP caseworkers must evaluate your eligibility by reviewing the application you submitted and any additional documents you provided.

If the caseworker notices that information is missing or documents are needed, he or she will contact you. After your information has been reviewed, you will be notified about whether your application is approved or denied.

If you receive a notice letter stating that your application is rejected, there will be information included in the letter that states why you do not qualify. If you feel that the decision is unfair or incorrect, you have the right to request an appeal to have your case re-evaluated.

If you are determined to be eligible for the Children’s Health Insurance Program, you will be notified by letter regarding the type of coverage you have and your coverage start date. You will also receive information about your CHIP benefits and costs if there is a cost applicable in your state.

It is important that you review all of the information enclosed so that you are well-educated on the coverage you and your family are receiving.