Children’s Health Insurance Program (CHIP)

CHIP for Everyone

Benefits under the Children’s Health Insurance Program (CHIP) used to only be available to low-income families, and now the income limit has been removed. Every uninsured child and teenager under age 19 who does not qualify for Medical Assistance can receive covereage under CHIP. There are also no exclusions due to pre-existing conditions in CHIP.

As a result of the Children’s Health Insurance Program Reauthorization Act being passed in 2009, millions of children and families have received Medicaid and CHIP benefits that would not have prior to the law being passed. CHIP works as a part of Medicaid to provide more children in low-income families with health insurance. CHIPRA made it possible for more individuals to be eligible to receive benefits under Medicaid and making it easier to enroll.

Since its inception in 2009, CHIPRA will have provided $33 billion in government funds for children’s medical care over the span of four and a half years. It is estimated to cover 4.1 million children through Medicaid and CHIP who would have been without insurance by 2013.


CHIP Benefits

Through CHIP, children can get coverage for the following benefits and more:

  • Regular check-ups
  • Prescription medications
  • Up to 90 days hospitalization per year
  • Mental health services
  • Dental care
  • Maternity care
  • Immunizations
  • Medical equipment
  • Substance abuse treatment
  • Rehabilitation therapies
  • Partial hospitalization for mental health care


The Cost of CHIP

For most families, there is no cost for CHIP coverage. There is an income limit for free CHIP benefits, however the monthly premiums and co-pays that will be incurred are very low.

In the state of Pennsylvania, the average premium for a family of four that makes $44,701 is $43 monthly per child age 0 – 18. If their income was 44,700, they would be eligible for free CHIP coverage. The highest average premium is $195 monthly for a family of four that makes over $67,051 a year, or an individual who earns 32,671 per year.