Children’s Health Insurance Program (CHIP)
What is CHIP and who is covered?
The Children’s Health Insurance Program, or CHIP, is government insurance that provides low-cost health coverage to children in families that earn too much money to qualify for Medicaid. CHIP may be an option for lower income families with children or parents who have cancer.
Each state has its own CHIP program, but your state may call it a different name (for example, in Georgia it is called PeachCare). The state sets up guidelines about who is eligible, benefits, and cost. The program covers doctor visits, medicines, hospitalizations, dental care, eye care, and medical equipment.
You can apply for CHIP for your child anytime. In many cases, if you qualify for Medicaid your children will qualify for either Medicaid or CHIP.
How do I reach CHIP?
To find out more about CHIP, call 1-877-543-7669 (1-877-KIDS-NOW). You can also go to the CHIP website, www.insurekidsnow.gov, to learn more about it and find your state’s CHIP program.
Does CHIP count as health insurance coverage?
If you have Medicaid or CHIP coverage, you’re considered covered under the health care law. You don’t have to buy a Marketplace insurance plan. You also don’t have to pay the fee that people without health coverage must pay at tax time.
If you go your state health insurance Marketplace and fill out an application, the Marketplace will tell you whether your child qualifies for CHIP.
If your child has a long-term disability
Your child, if younger than age 18, might qualify for Supplemental Security Income (SSI) if he or she has a physical or mental condition that meets Social Security’s definition of disability for children. SSI is income that can help with your child’s health needs or expenses (see our information on SSI).
When your child gets SSI, Social Security will also refer you to places where you can get health care services for them , including Children’s Special Health Services, Children’s Medical Services, and the Handicapped Children’s Program. Most programs provide services through clinics, private offices, hospital-based outpatient and inpatient treatment centers, or community agencies. All of these are different from CHIP. Talk with your state health department or your cancer team social worker for more details.
Even if your child doesn’t get SSI, one of these state programs may be able to help your child. Local health departments, social service offices, or hospitals should be able to connect you with your local Children with Special Health Care Needs program. Children older than 18 may qualify for other Social Security help.
Can my child have a Marketplace plan and Medicaid or CHIP?
If you or your child are enrolled in a Marketplace plan and find you’re eligible for Medicaid or CHIP, you must end the Marketplace plan as soon as you know for sure you or your child are eligible for Medicaid or CHIP coverage. If you don’t quit the Marketplace plan, you (or the person who claims you or the child on their taxes) may need to pay back the advance payments of the tax credit received for the months you or your child qualified for Medicaid or CHIP coverage.
Along with the American Cancer Society, other sources of information and support are listed below.
US Department of Health & Human Services
For the most up-to-date information on health care and insurance laws and how they might affect you
Medicaid and CHIP – US Department of Health and Human Services
Toll-free number: 1-877-696-6775
To learn more about coverage and eligibility: Your state social service or human service agency can give you the best answers to questions about your benefits, eligibility, and fraud. To get to your state’s Medicaid/CHIP website, go to www.medicaid.gov/Medicaid-CHIP-Program-Information/By-State/By-State.html
Social Security Administration. Social Security Benefits for Children with Disabilities, January 2015. Accessed at http://www.ssa.gov/pubs/EN-05-10026.pdf on May 14, 2015.
US Centers for Medicare & Medicaid Services. Cancelling a Marketplace plan when you get Medicaid or CHIP. Accessed at https://www.healthcare.gov/medicaid-chip/cancelling-marketplace-plan/ on May 14, 2015.
US Centers for Medicare & Medicaid Services. Medicaid and CHIP Coverage. Accessed at https://www.healthcare.gov/medicaid-chip/ on May 14, 2015.
US Department of Health and Human Services. Connecting Kids to Coverage. Accessed at http://www.insurekidsnow.gov/ on May 14, 2015.
Last Medical Review: November 19, 2015 Last Revised: February 29, 2016