Understanding PA Chip Insurance

Pennsylvania Children’s Health Insurance Program, or PA CHIP, is a low-cost health insurance program for children in Pennsylvania. It offers comprehensive coverage to children who are not eligible for Medicaid and whose families are not able to afford private insurance. This article will provide an in-depth look at PA CHIP insurance, its benefits, and how to apply for this program.

Who Can Qualify for PA CHIP?

PA CHIP is available to children under the age of 19 who are legal residents of Pennsylvania and are not covered by any other health insurance. Eligibility is based on income and family size, and the program offers coverage to families with incomes up to 200% of the federal poverty level. This means that a family of four earning up to $52,400 annually may be eligible for PA CHIP insurance.

In addition, children may qualify for PA CHIP if they are not eligible for Medicaid or any other health insurance programs. This includes children whose parents have private insurance but cannot afford to add their children to their plan.

Benefits of PA CHIP Insurance

PA CHIP provides comprehensive health insurance coverage to children, including preventative care, doctor visits, specialist care, hospitalization, and prescription drugs. Some of the benefits of PA CHIP insurance include:

Benefits
Coverage
Doctor Visits
Fully Covered with $5 Copayment
Emergency Care
Fully Covered
Inpatient Hospitalization
Fully Covered
Prescription Drugs
Covered with $5-$15 Copayment
Vision Care
Covered with $10 Copayment
Dental Care
Cleanings and Exams Covered, Restorative Services with Copayments

In addition to these benefits, PA CHIP also covers mental health services, substance abuse treatment, and rehabilitation services. Children with special health care needs may also receive additional services through the CHIP Special Needs Program.

How to Apply for PA CHIP Insurance

Applying for PA CHIP insurance is a simple process. Families can apply online through the COMPASS website, or by filling out a paper application and mailing it to the CHIP program. To apply, families will need to provide information about their household income, citizenship status, and other basic information about their child.

Once the application is received, families will be notified of their eligibility status within 30 days. If approved, families will receive a member ID card and can begin using their benefits immediately.

Frequently Asked Questions

1. How much does PA CHIP insurance cost?

PA CHIP insurance is low-cost or free, depending on the family’s income. Families with incomes up to 150% of the federal poverty level pay no premiums, and families with incomes between 150-200% of the federal poverty level pay low monthly premiums.

2. Is dental care covered under PA CHIP insurance?

Yes, PA CHIP covers cleanings and exams, and restorative services are covered with copayments.

3. Can children with special health care needs apply for PA CHIP insurance?

Yes, children with special health care needs may be eligible for additional services through the CHIP Special Needs Program.

4. How long does it take to receive a decision on my PA CHIP application?

Families will be notified of their eligibility status within 30 days of submitting their application.

5. Can I apply for PA CHIP insurance any time of the year?

Yes, families can apply for PA CHIP insurance any time of the year.

Conclusion

PA CHIP insurance provides an affordable option for families who are not able to afford private insurance or are not eligible for Medicaid. With comprehensive coverage for children, families can ensure their children have access to the healthcare services they need. Applying for PA CHIP insurance is a simple process, and families can receive a decision on their eligibility status within 30 days.