CHIP

Children’s Health Insurance Program (CHIP)

On February 4, 2009, President Obama signed the Children’s Health Insurance Program Reauthorization Act (CHIPRA), which renews and expands coverage of the Children’s Health Insurance Program (CHIP) from 7 million children to 11 million children.  CHIP was previously known as the State Children’s Health Insurance Program (SCHIP).  If you have uninsured children or are even paying more than $100 dollars for their health insurance coverage and meet the financial criteria you will want to look into this program.

For more information on the CHIP program in your state, please visit your state’s health insurance page.

 

About CHIP

Originally created in 1997, the Children’s Health Insurance Program (CHIP) is a state and federal partnership that provides low-cost health insurance coverage for children in families who earn too much income to qualify for Medicaid but cannot afford to purchase private health insurance coverage. States have considerable flexibility to establish income eligibility rules for CHIP, but children enrolling in the program must be otherwise uninsured.

Within federal guidelines, each state determines the design of its individual CHIP program, including eligibility parameters, benefit packages, payment levels for coverage, and administrative procedures. States have flexibility in designing the benefit package for CHIP, but states are required to cover routine check-ups, immunizations, dental, inpatient and outpatient hospital care, and laboratory and x-ray services. Preventive care must be provided at no cost to the family; but premiums and other cost-sharing may be required for other services, within certain limits.

On February 4, 2009, President Obama signed the Children’s Health Insurance Program Reauthorization Act (CHIPRA), which provided funding to renew and expand CHIP coverage. This new legislation preserves health coverage for millions of children who already rely on CHIP, and provides resources for states to offer CHIP coverage to millions more uninsured kids.

CHIP served more than 7.3 million children in fiscal year 2008. The Congressional Budget Office estimates that, by 2013, states will be able to provide coverage to an additional 4 million children who would otherwise be uninsured.

 

Access to CHIP

Each state and U.S. Territory operates a CHIP program, although most states have unique names for their programs. For more details on the CHIP program in your state, go to the Public Assistance section of the state in which you reside.

In addition to renewing the CHIP program, the new legislation makes it easier for certain groups to access CHIP health care, including uninsured children from families with higher incomes and uninsured low-income pregnant women.

Centers for Medicare & Medicaid Services (CMS) enrollment data based on state reports show that 7.4 million children were enrolled in CHIP at some point during Federal fiscal year (FFY) 2008, compared to 7.1 million for fiscal 2007.  During FFY 2008, there were 334,616 adults covered with CHIP funds.

 

Children’s Health Insurance Program (CHIP) Directors. Each State, Territory, and the District of Columbia has a coordinator for the SCHIP program who is responsible for the administration of the approved SCHIP state plan.

 

Children’s Health Insurance Program (CHIP) Waivers and Demonstrations. The Social Security Act authorizes multiple waiver and demonstration authorities to allow states flexibility in operating Medicaid programs and CHIP programs. Each authority has a distinct purpose, and distinct requirements.  For additional information, click on the Medicaid and CHIP Quality Practices link below.

 

CHIP Eligibility

Families who earn too much to qualify for Medicaid may be able to qualify for CHIP.

Families that do not currently have health insurance are likely to be eligible, even if you are working. The states have different eligibility rules, but in most states, uninsured children under the age of 19, whose families earn up to $46,100 a year (for a family of four) are eligible. For little or no cost, this insurance pays for:

  1. doctor visits
  2. immunizations
  3. hospitalizations
  4. emergency room visits

For contact information for your state or to read specific information regarding eligibility in your state please visit your state‘s Public Assistance section.

 

Facts and Figures

Facts and Figures

  • CHIP alone served more than 7.7 million children by 2010.
  • CHIPRA added $33 billion in federal funds for children’s coverage over the next four and one-half years (2009 – 2013).
  • In 2011, 7.6 million children under 19 were uninsured.
  • The uninsured rate for children in poverty in 2011, at 13.8 percent, was higher than the rate for all children at 9.4 percent.
  • The vast majority of uninsured children (88.2 %) come from families where at least one parent is working.
  • 71 percent of uninsured children in the U.S. have family incomes below 200% of the Federal Poverty Level ($38,180 for a family of three in 2012).
  • 88 percent of all low-income uninsured children are eligible for Medicaid or CHIP.