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Learn About CHIP in Washington D.C.

Washington D.C. CHIP is called the DC Healthy Families program and is administered by the Department of Health Care Finance (DHCF) throughout the district. The program is combined with the Medicaid insurance program to offer free or low-cost health insurance to families and children that meet the low-income eligibility guidelines. The program also includes special coverage for newborn babies or children with disabilities who are currently living in low-income households. The purpose of CHIP insurance is to provide all families with access to affordable health care for their children. This insurance coverage allows these families to keep their children healthy and thriving without facing medical debt. Children who are provided with adequate medical care are proven to do better in school and live healthier lives.

The federal name for this program is the Children’s Health Insurance Program, and the federal government sets basic program conditions while allowing states to implement the program and make some changes. DC Healthy Families sets some citizenship, residency and income guidelines that must be met by applicants for coverage to be provided. Residents whose children cannot afford private health insurance and are currently uninsured should review these requirements and the benefits that are provided through the program. If they feel their children meet these qualifications and they are interested in obtaining health care, they should follow the application process for the program. To find out more about how this DC CHIP and Medicaid combination program is assisting low-income residents throughout the state and to learn how to apply, DC residents should read the following sections.

What is CHIP in Washington D.C.?

Health insurance for kids in Washington D.C. who live in families with low incomes is provided through the DC Healthy Families program. Both federally funded programs, CHIP and Medicaid, are combined through this program, which allows families to obtain comprehensive medical insurance coverage if they meet the program guidelines. In some cases, these families are responsible for paying copayments for medical services they seek, but these charges are always affordable. The purpose of the program is to ensure all residents, regardless of income, have access to important health care without facing medical expenses that can put them into debt.

In addition to DC CHIP benefits for medical procedures and services, the program also provides dental and vision coverage for applicants who meet all eligibility guidelines. These benefits ensure that children can maintain their dental and eye health throughout their growing years. With the help of this coverage, parents and guardians can seek treatment and preventative care for their children without paying the expensive costs that are usually associated with these services. To learn more about CHIP program basics, applicants can download our CHIP guide today.

Who does Washington D.C. CHIP cover?

To meet the Washington D.C. CHIP eligibility guidelines, the entire application process must be completed with DHCF, which includes providing documentation and proof of statements made on the application. The department is mostly concerned with families meeting low-income guidelines and proving they do not currently have health insurance through other sources. More specifically, the qualifications for the program include:

  • The child applying for coverage must be younger than 19 years of age.
  • Low-income. The household the child lives in must meet low-income criteria set by the program. These guidelines are slightly higher than the guidelines for Medicaid, but are a percentage of the Federal Poverty Level (FPL).
  • Residency status. The child must prove he or she lives full-time in Washington D.C.
  • To qualify for coverage, the applicant must be a U.S. citizen or legal permanent resident. The parent or guardian is not required to prove his or her citizenship status, unless additional benefits are applied for.

Additionally, the applicant must indicate on the DC CHIP application that he or she is not currently enrolled in any other health insurance, either through a private insurer or through another government program. Pregnant women may also be eligible for coverage under the DC Healthy Families program.

How to Apply for CHIP in Washington D.C.

Parents, guardians or full-time caretakers can apply for the Washington D.C. child health insurance plan for their children. Since the application asks for income information, Social Security Numbers and other complicated data, parents are encouraged to complete this process to determine if their children are eligible for coverage. The process can be completed at any time and there is no specific enrollment period for the DC Healthy Families program.

To determine who qualifies for CHIP in DC, parents can complete applications for their children:

  • By mail.
  • Over the phone.
  • By fax.

Most applicants prefer to apply for CHIP online, since they can use their online accounts with DC Health Link to check the statuses of their applications. The online system also provides information on participating medical providers and benefits covered, including copayments. Potential applicants who prefer not to apply online can download and print blank applications through the same website.

What is included with Washington D.C. CHIP coverage?

Washington D.C. CHIP coverage is comprehensive and was designed to meet the needs of all children living in low-income households. Medical services that are deemed to be either preventative or necessary by healthcare professionals are usually covered by program benefits. However, beneficiaries should keep in mind that while premiums are not charged, they may be responsible for copayments when attempting to utilize these benefits.

In addition to medical coverage, the program also includes CHIP dental coverage, which can be utilized by contacting a dentist who participates in the program. Additionally, beneficiaries can find local eye doctors that accept this type of insurance so their children can attend regular eye exams. To find out more about the services and treatments that are covered by CHIP, download and read through our comprehensive guide.

How much is CHIP health insurance in Washington D.C.?

Washington D.C. CHIP is designed to be affordable health insurance coverage for children residing in low-income households. Therefore, the program does not charge recipients any monthly premium charges, unlike private health insurance companies. While beneficiaries are not required to pay for this insurance monthly, they may be responsible for copayments.

When attempting to utilize CHIP benefits in DC, beneficiaries may be asked to pay affordable copayments before treatments or services are provided. These copayments may vary, depending on the medical care that is sought, but they are always low and generally affordable.

How long do CHIP benefits last in Washington D.C.?

Washington D.C. CHIP insurance expires every year, unless a beneficiary applies for renewal of the coverage. The insurance coverage is only renewed if it is determined that a beneficiary still meets the program’s eligibility guidelines. If a beneficiary applies for a renewal of coverage but his or her household now earns too much income or the enrollee is now insured elsewhere, the coverage will not be renewed through the DC Healthy Families program.