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Learn About CHIP by State

“What is CHIP?” is a question you may have because you discovered you have a household member that is eligible for the program. CHIP health insurance is designed for children of low-income families so they can receive the medical resources they need, including as dental and vision care benefits. CHIP is administered by each state, which means you will need to meet the eligibility requirements the program in your state has, such as income requirements, to enter the program.

Furthermore, when you discover that you qualify to enter the CHIP program in your state, you need to complete the application process. Depending on the state you live in, you may be able to submit an application online, in person, by mail or fax.  Also, the majority of states have cost sharing for the different services it provides. The amount of money you will have to pay out of pocket for a service in your state will be different than the cost of that same service in another location. To get an understanding on CHIP healthcare and how the program may vary from state to state, read the sections below.

Learn About CHIP Requirements by State

Each state has its own CHIP eligibility guidelines on who can receive benefits from the program. Every state has a different income criteria CHIP applicants must satisfy depending on the size of a family. For example, a family of four in Kentucky can have a monthly income of $4,560 or less to qualify for benefits. However, a family of four in Alabama can make up to $6,631 per month and still qualify for CHIP health insurance.

In addition, the state you live in may use other factors to determine what the income eligibility requirements are. For instance, there are some states that examine the Federal Poverty Level to determine what the income limit should be, such as Colorado and Tennessee. Also, there are states that change the income limit you can have to receive CHIP healthcare each year. You may meet the eligibility requirements this year. However, you may be unable to collect CHIP benefits next year.

Although each state has different guidelines you must satisfy to qualify for CHIP, there are also CHIP eligibility requirements that most, if not all, states have in common. For instance, you need to have legal presence in the United States. You must be a U.S. citizen or have proof of your legal status in the country. Additionally, you must be a resident of the state you are applying for. For example, your application will be denied if you attempt to apply for the CHIP program in Virginia if you live in California. The CHIP eligibility criteria for the state you live in can even include some adults for a short amount of time, Pregnant women may be eligible for certain benefits during and after pregnancy.

Learn About the CHIP Application Process by State

The CHIP application process is similar in each state. There is specific documentation you need to provide to program officials when submitting your CHIP application, such as your Social Security card and driver’s license. Also, the information that is required for you to provide in your application is similar. For instance, every application will require you to provide personal information about you and the members of your family, like the date of birth. Your personal information is what allows the CHIP program in your state to determine if it should approve or deny your application.

Moreover, each state has different methods by which you can apply for benefits. For example, if you live in Missouri you can submit a CHIP insurance application online, in person, by mail or fax. However, in New Jersey you can only submit your documentation using the state’s online portal.

Learn What CHIP Covers by State

Each state determines what resources its CHIP program will cover. However, there are similarities in every state’s coverage. For example, all states that offer CHIP benefits cover dental care and routine checkups. Regardless of the state beneficiaries live in, you will not have to pay a small copayment for those services.

Besides the basic CHIP coverage every state provides members of the program, many states offer additional resources. For instance, Nebraska offers members of the CHIP program coverage of chiropractic services, medical transportation and more. Additionally, Utah offers CHIP health coverage for residential treatment, physical therapy and more. For details on the variety of resources the CHIP health insurance program covers, download our free guide.

Learn About the Cost of CHIP by State

The majority of the states have cost sharing, which is the share of costs covered by CHIP that you pay out of pocket. Also, states determine which services require cost sharing, and the CHIP cost for each service. For instance, in Arizona you do not have copayments for the services you collect. However, in Montana you have copayments for home health services, chiropractor visits and more.

Moreover, states with CHIP that have premiums require you to make payments on a monthly basis. If you do not meet your payment deadline, you will face consequences. For example, there are states that will charge you a late fee if you do not meet the due date. Moreover, some states will remove you from the CHIP program.

Learn About CHIP Agencies by State

CHIP agencies throughout the country have different names. For instance, in Wyoming the program is known as Kid Care CHIP, and in North Dakota the program is called Healthy Steps. Furthermore, CHIP health insurance programs operate differently in every state. Each state has the option of having CHIP as a separate program from Medicaid, making it a program that works as an expansion of Medicaid or implementing both a Medicaid expansion and a separate CHIP program. For instance, New York and North Dakota have combinations of Medicaid expansions and separate programs. This means that both states receive federal funding to implement both a Medicaid expansion and separate CHIP health insurance program. For information on how the state agency in your state operates, download our comprehensive guide