Applying for CHIP

When applying for coverage from the Children’s Health Insurance Program (CHIP) you are required to adhere to certain procedures.

In general, eligibility for the program is determined based on factors such as income, residency and the age of the children involved. Income is also used to calculate the level of benefits you qualify for if you are approved for CHIP coverage.

Since this program is jointly funded at the federal and state level, each state is responsible for creating its own CHIP agency. As such, specific eligibility requirements and steps to apply may differ from state to state.

To ensure that you are prepared to apply for CHIP, it is beneficial to learn about the specific CHIP program in your state. It may be run in combination with Medicaid, or it may be considered a separate program. The following article outlines the basic eligibility requirements and application procedures in order to help you prepare.

CHIP Eligibility Requirements

In order to qualify for CHIP, you must meet certain requirements and provide supporting documents with your application. Most importantly, you must be the parent or guardian of a qualified child to enroll in the program. Some pregnant women and their unborn children may also have eligibility for CHIP. Other important factors that can affect your acceptance into the program include:

  • Income.
  • Age.
  • Residency.

Income

The CHIP program was created in order to provide low-income families access affordable healthcare for their children. As such, income plays an important role in determining eligibility for benefits.

Applicants must receive an income that is within the income limits established by their state CHIP program. These limits vary based on the applicant’s household size and the local median income level. Assets are not generally included in eligibility considerations, though some states do consider these factors as well.

Household income is also used to determine the amount of benefits an applicant qualifies for. In fact, depending on your income, you may qualify for free coverage. Otherwise, you may need to pay a small copayment or premium. In order to prove that they meet income guidelines, applicants must submit pay stubs, bank statements or similar supporting documents.

Age

State CHIP programs also consider the age of the child or children when reviewing applications. In general, applicants must have a dependent child who is 18 years old or younger in order to qualify.

Many states also categorize applicants based on the age of their children, and each category may have other additional requirements. Applicants who are pregnant are usually placed in a separate category and exempt from any age restrictions.

Residency

Residency is another important factor in CHIP qualifications. Since each state runs its own CHIP program, residents are required to apply in the state where they live to receive benefits. This is to ensure that families are not receiving benefits in more than one state at time. As such, applicants must provide proof of residency with their applications.

In addition, applicants must also provide proof of lawful presence in order to qualify. Non-citizens can receive CHIP benefits as long as they have valid documents proving their legal residency in the country.

Where to Submit a CHIP Application

The CHIP application process differs depending on where you live, since each state has its own version of the program. In some states, applications are completed and submitted online. The steps for this application method are outlined as follows:

  • Visit your state’s online CHIP portal.
  • Create an account.
  • Fill out the application and provide all necessary supporting information.
  • Sign the document with an electronic signature.
  • Submit your application.

The online method is often preferred because it allows applicants to easily track the status of their applications. In addition to receiving a confirmation email after submitting, applicants can usually log into their portal accounts to view their documents at any time.  

Other states require you to visit your local county CHIP office with your documents. You may still be able to print your application from your state’s CHIP website, or you can request an application during your visit.

In some cases, you may also have the option to apply over the phone. If you prefer, some states allow you to print and complete your application form at home, and either mail or fax it in.

How to Apply for CHIP

The first step in applying for CHIP is completing the application. Due to the specific eligibility requirements outlined by each state CHIP agency, applicants must prepare to provide detailed information on their applications. This includes information on each member of the household.

Once you fill out the application, you must also make sure you have the necessary supporting documents. These are used to verify the information provided on the application. In general, you will need proof of:

  • Identity.
  • Income and employment.
  • Lawful presence and local residency.

When your documents are ready, you can choose one of the submission methods outlined above. Keep in mind that the method you choose can affect how long it takes to hear back, as the mail-in method must account for shipping time. Missing documents or information on your application can also lengthen the process.

Regardless of the submission method you choose, you can expect to wait a few weeks to receive a notice of approval or denial. If you are denied, the notice you receive explains the reasons for the denial. It also outlines how you can proceed with the appeals process if you feel you were wrongly denied from the program.

Note: When you submit your application for CHIP, some states also automatically consider your eligibility for other programs as well. You will automatically be checked to see if you meet the eligibility requirements for Supplemental Nutrition Assistance Program (SNAP), cash assistance and Medicaid.

CHIP vs Medicaid

The CHIP and Medicaid programs frequently work in conjunction in order to ensure that children have access to the medical care they need. As such, there are many similarities between the programs. For instance, both are generally focused on families with dependent children. They also both use income and residency to determine who is qualified to receive benefits.

One of the biggest differences between CHIP and Medicaid is the established income limits. Medicaid qualifications regarding income are often stricter than those of CHIP. As a result, many applicants who are denied coverage from Medicaid due to income disqualification end up seeking and receiving coverage from CHIP instead.