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Learn About CHIP in West Virginia

West Virginia CHIP was created to assist low-income families throughout the state who do not currently have health insurance for their children. The program is federally funded throughout the country, but each state is individually responsible for administering program benefits. In West Virginia the Children’s Health Insurance Program (CHIP) is administered by the Department of Health and Human Resources (DHHR), through the Bureau for Children and Families. This department reviews applications to ensure they meet eligibility criteria and provides information on available benefits to families in need.

CHIP insurance is an important government assistance program because it ensures that all children have access to necessary and preventive health care. By providing growing children with proper health care and medical treatments, the program helps ensure that the children are more likely to grow up to become healthy and thriving adults. Residents wondering “What is CHIP and how does it assist children?” should review the following information about the program.

What is CHIP in West Virginia?

West Virginia CHIP and Medicaid are both government programs that are designed to ensure health insurance coverage for all residents throughout the state, regardless of income. However, the CHIP program only provides this low-cost or free medical insurance to children younger than 19 years of age. Since it is proven that healthy children grow properly and perform better in school, the government has allotted funds to this program to provide children living in low-income households with the chance to obtain medical services. By eliminating the medical costs and financial barriers to health care, low-income families are more likely to schedule preventive care appointments for children and seek treatments for medical conditions or emergencies.

The CHIP application process must be completed before an applicant can be approved for benefits. Parents or guardians are encouraged to complete the process for their minor children, since the application asks for important information, such as household income and Social Security Numbers (SSNs). Upon approval into the program, beneficiaries are provided with insurance cards, which they can take with them to seek services from participating medical providers. No monthly premiums are charged, but some services may include low copayments that beneficiaries must pay for treatment, services or prescription drugs.

Who West Virginia CHIP cover?

Low-income residents may wonder “What is CHIP and does my child qualify for benefits?” There are certain eligibility criteria for the program that must be met before insurance cards are issued. Generally, for an applicant to qualify for CHIP insurance in West Virginia, he or she must be:

  • Younger than 19 years of age.
  • A West Virginia resident.
  • Living in a household that meets low-income guidelines.
  • A U.S. citizen, national or legal alien.
  • Currently without health insurance.

Additionally, the applicant cannot qualify for Medicaid coverage. The low-income guidelines that determine CHIP eligibility in WV are calculated using the government’s Federal Poverty Level (FPL). This level changes each year, so the program’s guidelines can also change. These low-income requirements are also dependent on the number of household members in a family. The number of family members in a household should be equal to the number of members claimed on the household’s tax return.

To find out more about CHIP, download our comprehensive guide.

How to Apply for CHIP in West Virginia

You can get help with your West Virginia CHIP application by contacting a community partner agency. There are several ways to apply for program benefits, including online, by mail or in person. If you choose to complete the application in person, it is important to bring documentation and information with you to help you provide accurate and thorough answers. This documentation may include:

  • Paycheck stubs.
  • Information on other government benefits or child support you receive.
  • Information on other health insurance you are enrolled in.

To complete the application for CHIP online, you must visit the benefits website and create your own online account. Answer all questions as thoroughly as possible and submit your application before exiting the system. You can also choose to download and print a blank application to complete at home. Upon completion, sign and date the application for WV CHIP coverage and mail it to the address provided. You can call the program’s hotline during operating hours to speak with a representative and to ask questions about the application process at any time.

What is included with West Virginia CHIP coverage?

Since the West Virginia CHIP program’s goal is to provide comprehensive health coverage to children, most preventive and necessary medical services are covered under the plan. Additionally, there are CHIP dental services covered under the plan, as well as eye exams and other vision services. To utilize the program’s coverage, a beneficiary can only make appointments with medical providers that accept this type of insurance. If treatment is sought through a facility that does not accept these benefits, the program enrollee may be responsible for paying out of pocket for these medical expenses. Additionally, the medical provider must express that a service or procedure is necessary or preventive for the program to cover the costs.

How much is CHIP health insurance in West Virginia?

To maintain CHIP benefits in WV, there may be a monthly premium due for families who earn slightly higher incomes. The department maintains strict income guidelines that determine if a family must pay these low monthly premiums or if it is exempt from these charges. All program enrollees may be subject to copayments for certain medical treatments. These copays may vary, depending on the family’s income and the type of treatment requested. The copayments and premiums due depend on the type of plan the applicant was enrolled into upon acceptance into the program.

How long do CHIP benefits last in West Virginia?

In most cases, West Virginia CHIP lasts for one year. However, if a child turns 19 or obtains health insurance coverage elsewhere, he or she becomes ineligible to continue receiving program benefits. If after the first year of coverage, parents or guardians think that their children are still eligible for the program, they can submit a request to renew coverage. The department will analyze the beneficiary’s income and situation before confirming eligibility for another year of coverage.

To learn more about medical services and the benefits provided through the program, review our guide.