Children’s Health Insurance Program (CHIP)
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Julia Kagan is a financial/consumer journalist and former
senior editor, personal finance, of Investopedia.
What Is the Children’s Health Insurance Program (CHIP)? menfashdesign
The Children’s Health Insurance Program (CHIP) provides
medical coverage for individuals age 18 and younger whose parents earn too much
income to qualify for Medicaid, but not enough to pay for private coverage.
Congress passed CHIP in 1997 during the Clinton administration.
Key Takeaways
Understanding the Children’s Health Insurance Program (CHIP)
The Children’s Health Insurance Program (CHIP) is a U.S.
federal healthcare program administered and named differently by each state.
For example, the state of New York calls its program Child Health Plus while
Arkansas calls its program ARKids. Similar to the way Medicaid works, the
federal government provides matching funds to each state.
Responsibility for managing CHIP programs falls under the
state’s Medicaid administration. In many instances, these families are unable
to gain health insurance coverage for their children through an employer.
Families must apply for CHIP and many are unaware of the program’s existence.
In 2009, Congress allocated federal funds to help raise visibility and also
help more families enroll. Sometimes children will qualify for children’s
Medicaid rather than CHIP. An adult who lives more than half the time with the
child may apply for the child. ethicmenvoguee
Many medical services covered by CHIP are free but some
require a co-payment. Some states also require a monthly premium that cannot
exceed 5 percent of the annual household income. CHIP typically covers annual
check-ups, immunizations, doctor visits, hospital care, dental and vision care,
prescriptions, laboratory services, X-rays, and emergency services. Some states
also extend coverage to parents and pregnant women.
CHIP coverage can begin at any time throughout the year with
benefits becoming available immediately. Sometimes parents who qualify for
Medicaid can enroll their child in CHIP so they don’t have to buy the coverage.
CHIP Benefits
The benefits covered under CHIP are relatively standard,
although some could vary on a state-by-state basis. According to its website,
the following CHIP benefits are offered:
CHIP Eligibility
In most states, children up to age 18 are eligible for CHIP
benefits. The income cut-off depends on the size of the family and the state
they reside in. In addition, the following criteria for CHIP eligibility are
from the Centers for Medicare and Medicaid Services website:
Typically, a family of four earning up to $106,000 before
taxes (as of 2021) a year will qualify for CHIP, but the limits vary on a
state-by-state basis. businessdirectorypc
Special Considerations
When Congress passed the Affordable Care Act (ACA) in March
2010, many politicians and healthcare officials thought this new mandatory
health insurance program would replace the need for CHIP, but that did not
happen. Instead, we now have Medicaid, CHIP, and the ACA, so low-income
families have increased confusion on which options are best for them.
Benefits and co-payments are not consistent among the
various programs, so it's important to explore the many options before choosing
one. Given the uncertainty surrounding the ACA, it remains to be seen what
additional options and changes may be coming to affordable healthcare options
for low-income families.
CHIP Insurance FAQs
What Are the Income Limits for CHIP?
Income limits for CHIP depend on the state, but for the most
part, a family of four is covered if their annual income is $106,000 before
taxes.
What Services Does CHIP Cover?
CHIP covers basic healthcare, including vision and dental
care, prescriptions, emergency services, x-rays, sick visits, immunizations,
annual checkups, and mental health services for eligible children age 18 and
under.
Who Is Eligible for CHIP Insurance? allinternetbuziness
U.S. citizens or those who meet immigration requirements up
to age 18 are eligible for CHIP benefits if their family meets the CHIP income
requirements. You must reside in the state from which you are applying for CHIP
benefits.
U.S. Centers for Medicare & Medicaid Services.
"Eligibility." Accessed Aug. 9, 2021.
Congress. "H.R.2 - Children's Health Insurance Program
Reauthorization Act of 2009." Accessed Feb. 5, 2021.
HealthInsurance.org. "We’re a family of four with an
income of $47,000 a year. What kinds of subsidies are available to help us
purchase insurance through the exchanges?" Accessed Aug. 9, 2021.
InsureKidsNow.gov. "Frequently Asked Questions."
Accessed Aug. 9, 2021.
U.S. Centers for Medicare & Medicaid Services.
"Patient Protection and Affordable Care Act." Accessed Aug. 9, 2021.
InsureKidsNow.gov. "Frequently Asked Questions."
Accessed Aug. 9, 2021.