Childrens Health Insurance Program

CHIP or the Childrens Health Insurance Program provides free or affordable health insurance for children for more than 7 million youngsters. Therefore, before you consider paying for private health insurance, or not having any coverage at all, you really should look at this program.

This child health insurance program is organized by the United States Department of Health and Human Services, which matches federal funds to the individual states' funds to provide health insurance to lower income families who have children. The affordable health insurance for children was designed with the intention of covering uninsured children in families with incomes that are too low to allow them to pay for private health insurance, but too high to qualify for Medicaid.

Did you know that CHIP covers U.S. citizens along with immigrants who fulfill the eligibility criteria? Individual states design their own child health insurance program including:

  • The available benefits
  • The criteria of eligibility
  • Premiums and cost-sharing
  • Procedures relating to initial applications and renewals of those applications

Individual states decide on the benefits provided under CHIP, but – and make a note of this - all states must cover:

  • Routine immunizations
  • Routine check-ups
  • Dental care
  • Hospital care
  • Lab and x-ray services

Side Note

Children are allowed to receive free preventive care, but low premiums and other cost sharing may be required for other services. In general, children in families of four with incomes up to $44,100 per year are likely to be eligible for coverage. In many states, families with higher incomes can still qualify, so you must check the requirements for your particular state.

More Info

Here is more information you need to know about the Childrens Health Insurance Program. It comes under the Affordable Health Care for America Act, which was passed by the House on November 7, 2009, and the Patient Protection and Affordable Care Act, which was passed by the Senate on December 24, 2009; President Obama signed both into law on March 23, 2010.

On March 23, 2010, President Obama signed the Affordable Health Care for America Act that the House passed and the Patient Protection and Affordable Care Act that the Senate passed. From this, the Childrens Health Insurance Program developed and provides:

  • A provision in the legislation that individuals have to obtain health insurance
  • An expansion of the Medicaid program
  • Subsidies that will allow families with children to purchase insurance through a new health insurance exchange

Remember: according to the legislation mentioned earlier, the Childrens Health Insurance Program, or CHIP, will terminate at the end of 2013 and children in individual state child health insurance plan programs with incomes below 150% of the standard measure of poverty will be moved to Medicaid. Those children with incomes above 150% of the measure of poverty are to be brought into the new health insurance exchange.

If you enroll your children on CHIP, you should know about the Childrens Health Insurance Program Maintenance of Effort. The MOE, will be in operation between June 16, 2009 and December 31, 2013. This Maintenance of Effort requires that states maintain eligibility criteria and enrollment policies for Medicaid, and this form of affordable health insurance for children, as a condition of receiving the federal funding for Medicaid.

A state cannot change the criteria for enrollment by lowering the levels at which an individual can qualify according to their income, and states cannot make it harder to get coverage under the child health insurance plan than the conditions for enrollment as they were on March 23, 2010. These conditions include:

  • Periods of time spent waiting when uninsured
  • The number of times in a particular period of redeterminations
  • The documents required for an application
  • Fees for enrollment
  • Premiums

Be aware that when a state's budget does not cover the costs during the period 2011-2013, individuals who are not disabled and not pregnant, and whose incomes are above 133 per cent of the measure of poverty, will be exempt from the MOE. The MOE continues to apply for children in Medicaid expansion of child health insurance plan programs beyond 2013. Children with incomes above 150% of the measure of poverty enrolled in MOE-CHIP programs would keep Medicaid coverage and states would receive the improved Childrens Health Insurance Program match rate for such children, commencing in 2014.

Note that the Senate bill continues CHIP through 2019, and includes financing the Childrens Health Insurance Program through 2015. Children who are from families who satisfy the eligibility criteria for this form of affordable health insurance for children and who cannot enroll in the program owing to federal allotment caps must be screened to determine if they are eligible for Medicaid and if they are not, then if they would be eligible for tax credits. Now, this is part of a plan that is intended by April 2015 to be comparable to CHIP in the health insurance exchange. You must investigate the requirements for participation for your own individual state.

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