What is CHIP?

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What is CHIP?
* For CHIP Perinatal Information, click here*

The Children's Health Insurance Program (CHIP) was established as Title XXI of the Social Security Act. This program was created to provide States with funds to expand the provision of child health assistance to uninsured, low-income children. CHIP is designed for families who earn too much money to qualify for Medicaid, yet cannot afford to pay for private insurance. The parents in some of these families have jobs that do not offer health insurance for children. Other parents' jobs offer health insurance, but the insurance is so expensive that families cannot afford it.

Changes to the CHIP Program Effective September 1, 2007
The Texas Legislature made changes to the CHIP program that took effect on September 1, 2007. You can read more about the updated CHIP program by clicking here

Who is eligible for CHIP?
Any adult who lives with an uninsured child and provides care for that child can apply. This includes parents, step-parents, grandparents, other relatives, legal guardians or adult brothers or sisters.
In order for a child to be eligible for CHIP the child must be:

*Under age 19
*A U.S. citizen or legal permanent resident (the citizenship or immigration status of the parents does not affect the child(ren)'s eligibility and is not reported on the application
*A Texas resident
*Not eligible for Medicaid
*Residing family meets the CHIP Income Requirements

How much does it cost?
The cost will be based on family size and income. Higher-income families will pay minimal monthly premiums, which will cover all children in the family. Most families will have co-payments for doctor visits, prescription drugs, and emergency care. To view the co-pay levels, please click here.

What services are covered?
- Choice of doctors
- Regular checkups and office visits
- Prescription drugs and medical supplies
- Dentist visits, cleanings and fillings
- Access to medical specialists
- Shots and immunizations
- Hospital care and services
- X-rays and lab tests
- Mental health care
- Coverage for special health needs
- Coverage for pre-existing conditions
- Eye exams and glasses

How do you apply for CHIP?
There are several ways to apply for CHIP. Get detailed application information here

*Apply over the phone by calling 1-877-KIDS-NOW (1-877-543-7669). Operators are available for assistance between 8 a.m. and 8 p.m. Monday through Friday (except Federal holidays)
*Apply via mail by calling 1.877-KIDS-NOW (1-877-543-7669) to request an application to be mailed to you. You can also download an application to fill out and mail in here
*Apply via internet.

Enrollment Waiting Period?
Children enrolling in CHIP for the first time after being covered by private health insurance within three months of their application will have a 90-day waiting period before the benefits can be used. The waiting period begins once the application is complete and the family is determined eligible. There are several exceptions to this rule. Please call 1.877-KIDS-NOW (1-877-543-7669) if you have any questions.

As of September 1, 2007, children who are enrolled in CHIP receive 12 months of continuous coverage. Families must re-enroll their children every 12 months. Families with incomes between 185% and 200% of the Federal Poverty Level are subject to an administrative review of their income eligibility every six months, although families will only be contacted for additional information if there is a question about their eligibility status.

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CHIP Perinatal
Texas residents who are pregnant, uninsured and not eligible for Medicaid may qualify for CHIP perinatal benefits. Coverage starts before the child is born and continues after the child’s birth. Total perinatal coverage is 12 continuous months from the date the unborn child is enrolled. Benefits include:

Up to 20 prenatal visits.
Prescription drug coverage based on the current CHIP formulary.
Hospital facility charges and professional services charges related to labor with delivery only. Preterm labor that does not result in a birth and false labor are not covered benefits.
Two postpartum visits for the mother.
Regular check-ups, immunizations and prescriptions for the baby.
A full list of covered benefits is available here

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