Eligibility and Benefits
Many kids receive CHIP for free. Others can get the same benefits at a low cost. If your income is below the lowest amount listed, your child or teen will be referred to Medical Assistance. Use COMPASS to see if you qualify for CHIP and other human services in Pennsylvania.
If you have questions regarding CHIP eligibility, Please call the CSC at 877-395-8930 or 215-560-7226 in Philadelphia.
How do I know if my child qualifies?
Based on your family size and income, your child or teen may be eligible if they meet the following requirements:
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Under 19 years of age
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A U.S. citizen, U.S. national or qualified alien
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A resident of Pennsylvania
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Uninsured and not eligible for Medical Assistance
Most families receive CHIP coverage for free. Households with incomes above a certain level can receive comprehensive, quality CHIP coverage at a low cost. If your income is below the lowest amount listed in the above chart, your child or teen may be enrolled in Medical Assistance.
Whether CHIP is free or low-cost depends on the number of members in the household, as well as total household income. For free CHIP, there are no premiums or copays. Premiums and copays apply only for low-cost CHIP.
The above CHIP Income Guidelines Chart shows the average monthly cost per child to help families determine into which category they may qualify and for which type of coverage — free or low-cost CHIP. Remember: If your income is below CHIP limits, your family could be eligible for Medical Assistance.
Benefits
CHIP is there for your kids with quality, comprehensive health insurance coverage for routine doctor visits, prescriptions, dental, eye care and much more, including:
- Immunizations
- Routine checkups and well visits
- Prescription drugs
- Dental, vision, hearing services
- Emergency care
- Mental health benefits
- Hospitalization
- Durable medical equipment
- Substance abuse treatment
- Partial hospitalization for mental health services
- Rehabilitation therapies
- Home health care
- Maternity care
- Hospice and palliative services
- Medically necessary orthodontia
- Autism Spectrum Disorder and related services
For More Information
If you have questions regarding CHIP eligibility, please call the Statewide Change Center at 877-395-8930. If you reside in Philadelphia county, please call 215-560-7226.