What makes CHIP unique is that the program emphasizes preventive care—routine doctor visits, vaccinations, and dental services to keep kids healthy. It’s not just about emergency coverage; CHIP focuses on keeping children healthy from day to day.
CHIP is a lifeline for many families, providing a safety net for children who need affordable healthcare. Want to know how to qualify for this type of insurance? Let’s dive into the next slide to find out more about the requirements.
CHIP eligibility is primarily based on income, household size, and residency. Each state sets its own guidelines, so the exact qualifications can vary.
However, the program is designed to help families with children under the age of 19 who need affordable health coverage. It’s usually ideal for families making too much to get Medicaid, but not enough to afford private insurance.
Here’s a closer look at how children can qualify for CHIP:
- Income Guidelines: CHIP income limits are usually based on a Federal Poverty Level (FPL) percentage. Most states set the limits between 200% and 300% of the FPL. Income brackets may also vary by the child’s age, with different limits for younger children versus teens.
- Household Size: Eligibility is affected by the number of people in your household. The larger the family, the higher the income limit. This means a family of four will have a higher income threshold for CHIP than a family of two.
- Residency and Citizenship: To qualify for CHIP, your child must be a U.S. citizen or a lawful resident, and you must apply in the state where you live. Some states have additional residency requirements, such as living in the state for a certain period before you can apply. Children must also be under 19 years of age.
- Medicaid Expansion vs. Separate CHIP Programs: Each state can choose to offer CHIP as part of its Medicaid program or as a separate program:
- Medicaid Expansion: In some states, CHIP is an extension of Medicaid, and the two programs share similar eligibility guidelines.
- Separate CHIP Programs: Other states run CHIP as an independent program with its own rules, focusing on helping middle-income families.
- No Other Health Coverage: In most cases, children cannot already be covered by private insurance to qualify for CHIP. If a child has other health coverage through an employer or another plan, they may not be eligible for CHIP benefits unless that coverage is lost.
Special Circumstances: Certain states offer “buy-in” programs that allow families with incomes above the normal CHIP limits to access the program by paying premiums, especially if they face high medical costs or need additional healthcare coverage.
