Health Insurance For Children

Children Receive Free or Low-Cost Health Insurance Through CHIP

The Children's Health Insurance Program (CHIP) was established in 1997 to ensure that every child had access to comprehensive health care coverage even if their parents or custodians could not afford it. It was created to provide for children who lacked coverage because their parents or guardians made too much money to qualify for federal Medicaid coverage. CHIP insurance is available in 46 states plus the District of Columbia, and each program is run through the states, not the federal government. However, the federal government has made it easier to apply for the program by facilitating enrollment through the Affordable Care Act (AFC) website.

CHIP Coverage

Each state determines the full menu of available coverage options for applicants, but federal guidelines mandate that they must all cover the following minimum items:

  • Routine check-ups
  • Immunizations
  • Doctor visits
  • Prescriptions
  • Dental and vision care
  • Inpatient and outpatient hospital care
  • Laboratory and X-ray services
  • Emergency services

Some benefits may be different from state to state.

Some states go beyond these federal mandates and offer additional coverage for reproductive health and care for pregnant women. CHIP has a new option which allows states to provide Medicaid and CHIP coverage to children and pregnant women who are lawfully residing in the US. Check the list of coverage options for your state when you apply.

CHIP Eligibility Requirements

Although state eligibility requirements vary, there are several federal criteria that applicants must meet to qualify for CHIP insurance.

  • The child must not currently be eligible for any other health insurance coverage through a parent or guardian.
  • The child and custodial applicant must not be eligible for Medicaid. Individuals cannot receive Medicaid and CHIP funds simultaneously.
  • The custodial applicant must prove that he or she cannot afford to pay for an individual insurance policy.
  • The household income for a family of four must be at or below $47,700 per year.
  • Children must be 19 or younger.

Program Costs

The costs for the program vary based on which state the child resides in. Some states charge a monthly premium for the plan, while other charge on a per service basis. The premiums and rates remain much lower than typically marketplace prices, to keep them affordable. Federal law requires that the state programs do not charge more than 5 percent of a family's annual income. In addition, routine exams and dental visits are always completely free of charge.

Applying for CHIP

The CHIP program is separate from the Affordable Care Act but parents can apply for it through the main ACA website. The site automatically enrolls children in the appropriate state program based on their address. Health care coverage begins as soon as the applicant's enrollment information is accepted. In addition, parents can register their children in CHIP at any time of the year. There are no open enrollment periods for the program, such as those that apply to the individual insurance mandates of the ACA.

The CHIP insurance program has provided necessary health care for millions of children since its inception. Even as Medicaid and general health insurance coverage options change, the CHIP program remains much the same but has instituted a more streamlined application process.

To learn more about CHIP, go to Insure Kids Now.

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