Many children across the country are in an unfortunate position where, although their family's household income is too high to qualify for Medicaid, they still need more affordable health insurance options to have their needs met. The Children's Health Insurance Program (CHIP), a joint venture between the federal government and all state governments in the nation, was created to help children with the uniquely troublesome dilemma of being ineligible for Medicaid but still in need of more affordably priced insurance.
CHIP was originally created as the result of the 1993 Clinton health care plan failing to gain approval. Senators Orrin Hatch and Edward Kennedy co-sponsored its creation in 1997 as the State Children's Health Insurance Program (SCHIP). Today, the commonly used abbreviation of the plan's title leaves out the original "S" for "State" to leave it as CHIP.
To accommodate children in need of coverage who are stuck in the "limbo" of Medicaid ineligibility due to a slightly higher family income, CHIP works closely with Medicaid itself to develop more comprehensive plans for them. While all states offer some form of CHIP coverage to children who qualify for it, the exact extent of the coverage offered to children differs depending on their state of residence in question.
While not all states in the nation offer the same benefits under their CHIP benefit provisions, all CHIP programs are designed to be fairly comprehensive. In addition to different forms of treatment intended to address various ailments and injuries, the basic fundamentals of general health care are provided as well. Core CHIP program benefits include the standard set of general health care services such as immunization procedures, check-ups, and prescriptions.
To be considered eligible for CHIP benefits, it is necessary for an applicant to either be the caregiver of a child younger than 19 or to be under 19 years of age themselves. Eligible applicants are U.S. citizens, nationals, permanent residents, legal aliens and U.S. nationals who are neither covered by Medicaid any form of health insurance.
Apart from the individual qualifications, there are also eligibility criteria based on the relationship between household size and maximum annual income level as well. For the most part, just about all children in every state whose families have an income that is twice that of the poverty level will be considered eligible for coverage.
For applicants who live in a household size of 1, the maximum annual income level permitted for CHIP coverage is $48,9240. For applicants who live in a household size of 8, the maximum income level permitted for CHIP coverage is $165,280. Between the household sizes of 1 and 8, the maximum permitted income level for CHIP eligibility increases by approximately $16,000-$17,000 for every additional individual in the household. For households that are occupied by a number of residents even greater than eight, exactly $16,720 is added for every additional resident.
Conditional Exceptions and Alterations
Though not all applicants for CHIP benefits are approved for coverage, the exact extent of coverage still varies among even those who meet the most basic criteria for eligibility. Those who are deemed eligible for CHIP coverage but still have an income level that straddles the line between Medicaid eligibility and ineligibility may find that their coverage terms include some cost-sharing and low premium payments for certain procedures.
Depending on the child's state of residence, the exact terms of eligibility for CHIP coverage may vary. CHIP benefits in certain states are occasionally referred to by different names than CHIP altogether, so it pays for the right amount of due diligence to be done in order to discover what term constitutes the equivalent CHIP benefits in one's particular region.
How to apply for CHIP coverage
The process of filing a complete application for CHIP coverage is not at all complicated. Applicants can inquire about their eligibility for CHIP at any time by calling their state Medicaid or CHIP agency, sending direct mail, arranging an in-person meeting at the state agency itself or simply filling out an online form. Applicants in every state can find out more information about their state's particular CHIP eligibility requirements visiting or calling Insure Kids Now.
Parents who apply for Medicaid coverage in their states will be informed of whether or not their children are eligible for CHIP coverage by default. There is no time of the year that the families of potential applicants are prohibited from inquiring about their eligibility.