The Children’s Health Insurance Program (CHIP) is a subsidized form of healthcare targeted at families who have modest incomes but still do not qualify for Medicaid assistance. It offers health services at reduced rates, with exact prices varying according to family size and household income.
Benefits
Like Children’s Medicaid, CHIP subsidizes the costs of many different health services, including:
- Pre-existing conditions
- Doctor’s office visits (i.e. check-ups, well-baby)
- Dental check-ups/braces
- Eye exams/glasses
- Immunizations
- Physical, speech and occupational therapies
- Transplants
- Hospital Care and surgery
- Specialist Care
- Labs and X-rays
- Prescription drugs
- Mental health services and substance abuse treatment
- Emergency services
Costs
Unlike Children’s Medicaid, which is a free federal program, CHIP is a cost-sharing program based on a sliding scale of family size and household income. Families pay no more than $50/yr with some families paying nothing at all. Several costs are associated with enrolling in CHIP:
- Renewal required every 12 months
- Yearly enrollment fee
- Co-pays (from $3-$10) for certain services (doctor’s office, emergency room, prescription drugs).
Eligibility
Age Requirement
Child must be aged 0-18.
A Social Security number must be provided for each child.
US Citizen
Child must be US citizen, legal permanent resident, or refugees. The immigration status of the parents does not matter.
Proof of US citizenship (ie: U.S. passport, Certificate of Naturalization, U.S. birth certificate, hospital record of birth, or Medicare card) and, if applicable, proof of immigration status (ie: resident card (I-551), arrival/departure form (I-94), or papers from the U.S. Citizenship and Immigration Services), must be provided.
Texas Resident
Income Requirement
Household income must be between 100-200% of the Federal Poverty Line. Use the CHIP/Children’s Medicaid Income Checker to easily determine if a child qualifies.
Proof of each household member’s income (at least one pay stub from the past 60 days, self-employment records, or a signed statement from the employer) must be provided. The statements must be dated and show the employer’s name, address, phone number, and signature.
Miscellaneous
Applying
Application Form
The CHIP application (the same application as Children’s Medicaid’s) is an 8 page form with included instruction pages. There are various methods of filling out and sending in the application form. In addition, CHIP requires additional documents that need to be mailed or faxed in. It may take up to 45 days for CHIP to process your application.
- Apply by mail or by fax using a printable paper CHIP/Children’s Medicaid application (English, Spanish), or by picking one up from any HEB pharmacy. Mail the completed application and additional documents to CHIP or fax it to 1-877-542-5951.
- Apply online through the CHIP/Children’s Medicaid website (Internet Explorer 8 works best). You can change the text size and language (English, Spanish) by clicking the buttons in the upper right-hand corner of the page. Applying online allows the applicant to not only apply and check on the status of their case, but to pick their healthcare plans and providers, renew their benefits, and update their contact information.
- Apply over the phone by calling 2-1-1 OR toll-free 1-877-447-2839 (Monday-Friday 8am-8pm Central Time). The CHIP representative will fill out your application over the phone then mail it back to you for you to sign. Mail the completed application and additional documents to CHIP or fax it to 1-877-447-2839.
Other Documents
- Proof showing facts about people applying for benefits: Social Security number, US citizenship, and immigration status
- Proof showing money coming into the home (income): Proof of money from jobs, child support received, loans/gifts (someone paying the bills for you), Social Security or pension benefits, veterans’ benefits, workers’ compensation, or unemployment
- Proof showing costs to take care of others (expenses): Child support paid, Child care or other costs you pay to take care of others, alimony paid.
Application Status
- By phone: Call 1-877-447-2839
- Online: Your Texas Benefits
- If you already have an account, log in with either your user name and password OR your CHIP case number and password.
- If you sent in your application by mail or fax, a temporary username and password were sent by letter or email. Log in using this provided information and change your username and password.
Get help with the application process
- Visit the CHIP/Children’s Medicaid “Get Help” subpage to get answers to commonly asked questions about the application
- Visit the CHIP/Children’s Medicaid “Get Help” subpage and search “Harris County” to find the nearest qualified person who can walk you through the CHIP application process.
- Call toll-free 1-877-447-2839 for any questions related to the application or additional documents.
CHIP Perinatal
CHIP Perinatal coverage provides prenatal care for the unborn children of low-income women who do not qualify for Medicaid, either due to income level or immigration status. Once born, the child will receive CHIP benefits for the duration of the 12-month coverage period. CHIP Perinatal only covers cost of care related to the health of the child, not the mother.
FAQ
A: No. As long as documents are provided for the child, the immigration status of the parents does not matter.
A: A family’s total income determines whether their children are eligible for CHIP (100-200% FPL) or Medicaid (<100% FPL).
Useful Links
CHIP/Children’s Medicaid homepage:
http://www.chipmedicaid.org/
Comprehensive list of FAQs about CHIP: