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Learn About CHIP in North Carolina

The North Carolina CHIP insurance plan is known as NC Health Choice for Children (NCHC) and is the state’s designated health care program for kids. This comprehensive health care coverage plan is open to low-income families around the state. The Children’s Health Insurance Program (CHIP) is a jointly funded government assistance program that is offered in every state. To qualify for NCHC, applicants must provide proof of having an income too high to qualify for Medicaid but too low to afford private health coverage. NCHC offers low-cost health insurance for kids, which may be available to some applicants for free. Children must be younger than 19 years of age to receive benefits through this health care plan.

Each state is permitted to set the program benefits and application requirements in accordance with federal guidelines. CHIP eligibility in North Carolina differs from other states. For more information about the program, including the application process and services covered under the plan, continue reading the sections discussed below.

What is CHIP in North Carolina?

In North Carolina CHIP is provided through Health Choice for Children (NCHC). This plan is open to children younger than 19 years of age who do not qualify for Medicaid and are not covered by any other insurance plan. Some states offer a combination CHIP Medicaid coverage plan to its residents, but North Carolina separates these two programs into different coverage plans. NCHC gives children crucial access to medical care and services, including hospitalizations, checkups and prescription medications. Enrollees may qualify to receive free or low-cost insurance through NCHC.

CHIP coverage is determined by the state. The services offered through NCHC may be different than services offered in other states, as each one is responsible for setting the benefits. CHIP dental, vision and hearing coverage are typically included in this program. Also, the cost of the program depends on the applicant’s income and family size. While some enrollees are exempt from paying enrollment fees and copayments, others are required to follow a specific payment table.

To learn more about the services covered by the program and the costs associated with coverage, download our free and informative guide here.

Who does North Carolina CHIP cover?

North Carolina CHIP eligibility requirements are determined each year by the health department. To receive benefits, all applicants must meet these conditions. To enroll in the state’s child health insurance plan, children must be younger than 19 years of age and unable to receive Medicaid coverage. Likewise, children cannot be covered by any other private insurance plan. Families must show proof that their income falls within a certain range to receive benefits. Furthermore, all enrollees must be North Carolina residents and U.S. citizens, nationals or qualified noncitizens.

During the application process, applicants must provide information about their income, residency, immigration status and household size. Upon reviewing the application and all required documents, the state determines eligibility status. If you are wondering, “Can I get health insurance for my child only?” you will be glad to learn that this plan is specifically designed to insure children who would otherwise not have health coverage.

How to Apply for CHIP in North Carolina

Applicants must complete the CHIP application process before receiving access to important health coverage and medical services in North Carolina. The application process demands certain pieces of information from candidates, such as documents that prove income and residency. This information is necessary to confirm that applicants meet all the conditions of the program. The CHIP office, otherwise known as the North Carolina Department of Health and Human Services (NCDHHS), reviews all applications and notifies candidates if they are eligible.

You can apply for CHIP online using the web system provided by the state’s health department. This is the fastest way to determine if you qualify for health care coverage. After creating an online account, you can easily upload the documents needed to prove your eligibility.

Alternatively, you can apply for CHIP benefits in person at your local county office. However, you should complete as much of the application as possible before visiting the office. This helps speed up the application process and allows you to determine your eligibility much quicker.

Another way to apply for coverage is to print out a paper application, complete it and mail it to your local office. You may also drop off a completed application at one of these offices.

During the CHIP application process, you will likely need to provide proof of meeting the requirements of the program, such as submitting:

  • Proof of identity.
  • Proof of income.
  • Proof of residency.
  • Proof of citizenship.

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

What is included with North Carolina CHIP coverage?

CHIP insurance in NC allows children younger than 19 years of age to receive free or low-cost health care coverage. Coverage is standard through the NCHC program, so all eligible enrollees have access to the same services. However, these services may come with different costs based on the income and household size of the applicant.

Enrollees receive many CHIP benefits once they are approved for coverage through NCHC. Some of the covered services include:

  • Doctor visits.
  • Hospital stays.
  • Lab tests.
  • X-rays.
  • Prescription medications.

CHIP coverage in North Carolina is not limited to the services listed above. Before seeking treatment, you must ensure that your health care provider accepts NCHC. This is the only way to guarantee that your child’s treatment will be covered. Receiving care from out-of-network providers may result in significantly higher fees.

How much is CHIP health insurance in North Carolina?

CHIP insurance in North Carolina may be available at no cost for qualifying enrollees. Those who provide income documents that reveal they fall below a certain percentage of the Federal Poverty Level (FPL) may qualify for free or reduced coverage. The cost of the program can only be determined after the state processes the application.

The Children’s Health Insurance Program in North Carolina requires individuals to pay fees for each year of service. These fees are waived for certain low-income applicants. Annual fees range between $50 and $100 dollars per family. Likewise, some enrollees are required to make copayments for common services. The amount of these copayments depends on the enrollee’s income and family size.

How long do CHIP benefits last in North Carolina?

CHIP benefits are valid for a period of 12 months from the date of enrollment. Before the 12-month period is up, enrollees must renew their benefits. NCHC officials send out notices to all enrollees reminding them of their renewal period. The state must re-examine the information of all beneficiaries to confirm that they still meet the requirements of the program.

When it is time to renew CHIP coverage, you must submit all necessary documents and respond to official notices in a timely manner. Failing to respond to state documents puts you at risk of losing coverage. You may be able to renew CHIP online if the renewal notice permits it.

During the renewal period, you must report any changes to the state. Changes to your address, household size or income may affect your eligibility status. Thus, you must notify the NCHC officials to determine if you are eligible for coverage for the following year.