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All About CHIP Insurance

Having to face healthcare expenses without insurance coverage is impossible for most families. Families who need help paying for healthcare for their children may qualify for CHIP insurance coverage. Read on to find out what CHIP is and who’s eligible for this kind of health insurance program.

What Is CHIP Insurance?

CHIP is the acronym for the Children’s Health Insurance Program. Since 1997, low-income families with children who aren’t eligible for Medicaid have been able to apply for insurance coverage through CHIP. While CHIP typically provides affordable insurance for children and teens, it’s available for pregnant women in certain states, too.

CHIP benefits vary from state to state. But at the very least, the coverage provided through every state’s program is considered minimum essential coverage. That’s the kind of insurance coverage you need to have in order to avoid paying a fine. Having minimum essential coverage means that your health insurance plan provides basic benefits.

Anyone with CHIP insurance coverage can visit a doctor and receive prescriptions and immunizations. Children (and pregnant women) enrolled in CHIP also have access to emergency services, lab services, hospital care and dental and vision care.

How Children’s Health Insurance Programs Operate

All About CHIP Insurance

States primarily have control over their own Children’s Health Insurance Programs and the way they operate. But because they’re funded at the state and national level, they’re required to abide by rules and guidelines created by the federal government. Each state receives a certain amount of federal funding each year once it agrees to match a percentage of those funds.

Each state has its own version of CHIP. In three states, Connecticut, Washington and Arkansas, CHIP and Medicaid act as two separate programs. But most states have a program that offers a mixture of both kinds of health insurance coverage.

In a handful of cases, CHIP is run in tandem with Medicaid as an extension of the state’s program. In these instances, children enrolled in CHIP receive the same benefits as Medicaid recipients. And any premiums and healthcare costs that they must pay out of pocket are either low or non existent.

In some states, parents have to pay a monthly premium when their children have CHIP insurance. But premium costs are never more than 5% of a family’s annual household income. Generally, children with CHIP insurance coverage can go to the dentist or see a doctor for a routine checkup for free.

Qualifying for CHIP Insurance Coverage

According to the Medicaid and CHIP Payment and Access Commission, 9.46 million people had health insurance coverage funded through CHIP in fiscal year 2017. To find out whether your children are eligible for CHIP insurance coverage, you’ll need to check with your state’s individual program. If you’re pregnant, it’s best to find out whether you’ll be covered under your state’s program before applying for CHIP.

In general, in order to qualify for CHIP, your child must fall under the age of 19 and be a U.S. citizen, a permanent resident or a legal alien. The child must also be a dependent. So any legal guardian or relative who spends more than half the year with a child without insurance may be able to apply for CHIP insurance.

In order for a child to be eligible for CHIP coverage, a family’s pre-tax annual household income must also fall under a certain threshold, depending on the size of that household. If your children are eligible for CHIP, your income level determines whether you’re required to pay a premium and cover other costs such as a deductible or a copayment.

How to Apply for CHIP Insurance

All About CHIP Insurance

With most health insurance plans, you apply for coverage during the open enrollment period, which usually begins in the fall and ends at the end of January (unless your plan starts on Jan. 1). That changed for the 2019 coverage year, with the open enrollment period beginning in Nov. 1 and ending on Dec. 15.

But anyone who wants CHIP coverage (or Medicaid) for a qualifying child or pregnant woman can apply for health insurance at any point during the year. You can begin your application over the phone (by calling 1-800-318-2596) and have it mailed to your home. Or you can complete an application online through the Health Insurance Marketplace.

Tips for Improving Your Financial Life

  • Unexpected medical expenses can run your finances amok, which is why it’s so important to have an emergency fund in place. Stash three to six months worth of expenses in CDs or a high-yield savings account. That way, you’ll have a cushion if something comes up.
  • SmartAsset’s financial advisor matching tool can help you find a person to work with to meet your needs. First you’ll answer a series of questions about your situation and goals. Then, the program will narrow down your options to up to three experts in your area.

Photo credit: ©iStock.com/Christopher Futcher, ©iStock.com/didesign021, ©iStock.com/FatCamera

Amanda Dixon Amanda Dixon is a personal finance writer and editor with an expertise in taxes and banking. She studied journalism and sociology at the University of Georgia. Her work has been featured in Business Insider, AOL, Bankrate, The Huffington Post, Fox Business News, Mashable and CBS News. Born and raised in metro Atlanta, Amanda currently lives in Brooklyn.
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