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Learn About CHIP in Massachusetts

Massachusetts CHIP insurance is available to eligible children across the state. This government assistance program is funded jointly by states and the federal government. Otherwise known as the Children’s Health Insurance Program, this health coverage plan was created to fill any gaps in health insurance for families with incomes too high to qualify for Medicaid but too low to afford private health coverage. The program is available in every state. Getting health insurance for kids is made easier through this assistance program, as most children living in households with incomes up to 305 percent of the Federal Poverty Level (FPL) are covered.

Specific program benefits, procedures and requirements vary between states, as the program is administered at the state level in accordance with federal guidelines. The requirements of the program in Massachusetts are determined each year by state officials. To learn more about CHIP eligibility requirements, the application process and program benefits, review the sections below.

What is CHIP in Massachusetts?

CHIP in Massachusetts is formally known as MassHealth, the designated health insurance program for children younger than 19. CHIP Medicaid coverage and services are also available under the MassHealth system. The program provides children with access to important health care services, such as doctor visits, prescription drugs, hospital stays and much more. It is a low-cost insurance program designed to ease the financial burden of health care for families across the state.

CHIP coverage is not standard across the board. It varies between applicants based on a number of factors, such a household size, income and medical needs. For some, CHIP dental coverage is an integrated part of the MassHealth plan. For others, only certain medical services are covered under the program. Likewise, the cost of the program differs between applicants. Some beneficiaries may be exempt from paying premiums or copays.

To learn more about the benefits or covered services of the program, get our informative guide here.

Who does Massachusetts CHIP cover?

There are certain CHIP eligibility requirements that all applicants must meet before receiving program benefits. These conditions are determined at the state level, so requirements differ across the nation. The Massachusetts child health insurance plan is open to children younger than 19 years of age who do not qualify for Medicaid. They must have an income that is considered too high for the Medicaid program but too low to afford private health coverage. Furthermore, beneficiaries must be residents of the state and a U.S. citizen, U.S. national or qualified noncitizen.

The state determines who qualifies for CHIP after reviewing the application and all required documents. If you are wondering, “Can I get health insurance for my child only?” the short answer is that the program was created to cover children when there are gaps in a family’s coverage. Only those applicants who meet age, residency, income and health coverage requirements may enroll.

How to Apply for CHIP in Massachusetts

Completing a CHIP application is the first step toward receiving access to important health coverage and medical services in Massachusetts. Completing an application requires you to submit various pieces of information, such as income documents, information about your household size and details about your residency within the state. Applications are processed by MassHealth officials. If you are wondering how to apply for CHIP in Massachusetts, there are a few different ways you can begin. No matter the method you choose, the state will review your information and notify you of a decision in a timely manner.

You may apply for CHIP online using the web system connected with the state’s health insurance plans. Applying online is the quickest way to learn of your eligibility status and whether you qualify for coverage. You will need to create an account to proceed with the electronic application.

You may also apply for coverage by phone by contacting the state’s customer service line. Alternatively, you can mail your application and all required documents to the state’s processing center. Call the CHIP number to schedule an appointment at an enrollment center if you prefer to apply in person.

You may need to submit a variety of documents during the application process, such as:

  • Proof of identity
  • Proof of income
  • Proof of residency
  • Proof of citizenship
  • Information about current health insurance

For more details on how to apply in your state, click here to download our guide.

What is included with Massachusetts CHIP coverage?

MA CHIP insurance provides low-cost health care coverage and medical services to children around the state. The exact coverage varies between states. In Massachusetts, coverage depends on the applicant’s income, residency, immigration and health status. After submitting a CHIP application, the state health department notifies the applicant of which coverage type the child can receive. Applicants will receive the most complete coverage they can get based on their application.

There are six coverage types offered under the MassHealth system, some of which apply to the children’s plan. Standard CHIP benefits include services like doctor visits, dental cleanings, outpatient and inpatient hospital services, X-rays, lab tests, mental health services and vision care.

Other types of CHIP coverage are specifically reserved for those whose immigration status limits their health services and those who are disabled. Rather than applying for a specific type of coverage, applicants will submit a general application and await a decision from the state. The state notifies applicants of the type of coverage for which they qualify.

How much is CHIP health insurance in Massachusetts?

The cost of CHIP insurance in Massachusetts depends on a number of factors for each applicant. Anyone who applies for the program must submit documents that show income, residency and household size. These factors play a key role in determining the coverage type and cost of the insurance plan.

Under the Children’s Health Insurance Program, services like doctor visits and dental checkups are free. However, other medical services may require copayments. Furthermore, many beneficiaries will pay a monthly premium for services. Fortunately, Massachusetts CHIP members generally have low copayments for the services they receive.

How long do CHIP benefits last in Massachusetts?

All members must renew Massachusetts CHIP coverage each year to continue receiving benefits. The MassHealth program notifies all members when it is time to renew coverage. Children will continue benefitting from the program as long as they still qualify each year.

When your CHIP benefits expire, you will receive a renewal form by mail. Keep this notice for identification purposes when you renew your coverage. You can renew CHIP online for a fast and convenient process or renew by phone. Alternatively, you may return the notice in the mail.

No matter how you choose to renew your benefits, be sure to include any changes that could affect your coverage. These changes include a new address, changes in health coverage offered, new Social Security numbers and changes to immigration status.