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Learn About CHIP in Ohio

Ohio CHIP is formally and federally known as the Children’s Health Insurance Program. However, throughout the state, it is commonly referred to as Healthy Start. This program provides health insurance coverage to low-income children who do not qualify for Medicaid and do not have other types of medical insurance. CHIP insurance is focused on assisting families who make too much to qualify for Medicaid but who do not make enough income to afford private health insurance. By offering low or no copayments and no monthly premiums, the program includes extensive medical, dental and vision coverage while ensuring families do not go into debt obtaining health care.

To obtain this health insurance for kids in OH, potential applicants must meet all eligibility guidelines set for the program. They must also thoroughly complete the application process and wait until their coverage is active to seek treatment from participating medical providers. To find out more about the application process, qualifications for coverage and benefits offered through the program, review the following sections.

What is CHIP in Ohio?

In Ohio CHIP and Medicaid coverage are both under the Healthy Start program. However, CHIP is available for children who do not qualify for Medicaid due to earning higher incomes. Potential applicants should keep in mind, however, that the program carries its own low-income guidelines that must be met before coverage is provided. Upon enrollment, a beneficiary is provided with medical, dental and vision insurance coverage without paying monthly premiums. Care is offered to beneficiaries when they visit participating providers with their insurance cards. In some cases, these enrollees may need to pay copayments to receive treatment. However, these fees are usually very affordable.

The goal of the child health insurance plan is to ensure low-income families who do not qualify for Medicaid can still obtain health insurance coverage. This prevents these families from denying needed medical attention to children or from going into debt due to exorbitant medical expenses.

Who does Ohio CHIP cover?

Ohio CHIP eligibility guidelines must be met by program applicants before they are approved for enrollment in the program. Parents or guardians can apply for coverage for their children. If they also do not have insurance coverage elsewhere, they may qualify for benefits as well depending on their income. However, in order to meet eligibility for CHIP, these parents must be the sole caregivers to their children and meet all other eligibility guidelines. To qualify, children must be 19 years of age or younger and living with the parent or guardian who applied for them.

In some cases, CHIP benefits may extend to pregnant women. However, to meet all eligibility guidelines for the insurance program, an applicant must be:

  • An Ohio resident.
  • A U.S. citizen, national, permanent resident or legal alien.
  • Low-income, according to the guidelines set by the program.
  • Within the age requirements, as set by the program.
  • Not eligible for Medicaid.
  • Not currently insured by any other medical or health insurance.

Before a potential applicant assumes that he or she will not qualify for CHIP coverage in OH, the application should be submitted to the department. The guidelines are set in the state using the government’s current Federal Poverty Level (FPL). There are certain types of income that are discarded and not counted in the low-income calculations, making certain applicants eligible for benefits. Additionally, Healthy Start program representatives can assist applicants in learning about other health insurance programs, such as Medicaid, if they do not qualify for benefits.

How to Apply for CHIP in Ohio

If you are ready to complete the Ohio CHIP application, you can do so online, in person or by mail. To complete the application online, you must create an account with the Ohio Benefits website and complete the questionnaire. While a face-to-face interview is not necessary, you may be required to submit documents to prove the statements you made on your online application. This may include turning in utility bills to prove your residency status and paycheck stubs to prove your income.

If you do not want to apply for CHIP online, you can visit a local agency for assistance with the application process. You can also choose to download, print and complete the application at home. Then, you can mail the application or stop by a local agency to turn it in. Upon receipt, the agency will contact you by mail or phone to discuss the next steps in the process and your potential eligibility.

To find out when you can apply for CHIP, download our comprehensive guide.

What is included with Ohio CHIP coverage?

Before you apply for the program, you may wonder, “What is CHIP in Ohio and what benefits can I receive?” The program provides dental, vision and medical insurance coverage and benefits to you or your child after you have proven eligibility. Generally, you can receive medical treatments and preventive care from participating medical providers for free or by paying a small copayments. The most common services that are covered with CHIP insurance include:

  • In-patient hospital care.
  • Dental checkups.
  • Surgeries.
  • X-rays.
  • Prescription drugs.
  • Immunizations.
  • Lab services.

It is important that you only receive CHIP dental treatment, vision checkups and other medical services from participating providers who accept Healthy Start program insurance. If you seek treatment with a care provider who does not accept these benefits, you may have to pay out of pocket for the expenses.

How much is CHIP health insurance in Ohio?

The Children’s Health Insurance Program in Ohio does not require monthly premium payments from its beneficiaries. However, to seek medical treatment, program enrollees may be responsible for copayments. These copayments can vary and depend on the type of medical treatment sought.

To learn more about OH CHIP copayments, download and review our helpful guide.

How long do CHIP benefits last in Ohio?

Once it is determined that you meet Ohio CHIP eligibility guidelines and you are provided with an insurance card and a list of qualifying medical providers, you have coverage for one year. You must renew coverage after the one-year term policy expires, as long as you think you still qualify for benefits. If at any time you are no longer eligible for benefits due to age or an income change, you may not renew your enrollment in the program.