CHIP

What is CHIP?

The Children’s Health Insurance Program (CHIP), brought to you by Highmark, provides comprehensive health insurance coverage to children under 19 years old, regardless of household income. There are no medical questionnaires and no pre-existing condition limits.

A History with Highmark

Highmark helped set up the original CHIP program in Pennsylvania, which was signed into law in 1992. The first child was enrolled in May of 1993. Since then, the PA CHIP program has become the model for every other CHIP program across the country.

See why Highmark may be a great fit for your health care needs.

COVERAGE


What's Covered?

 

CHIP coverage can be used for the following health services:

  • Doctor visits
  • Immunizations
  • Annual checkups
  • Diagnostic testing and lab work
  • Prescription drugs
  • Dental care
  • Vision care
  • Hearing care
  • Emergency care
  • Outpatient surgery
  • Inpatient hospital stays
  • Mental health
  • Substance abuse programs
  • Home health care
  • Rehabilitation therapy

Covered Doctors & Facilities

COSTS


There are three different cost levels of CHIP:

 

  • Free CHIP
  • Low-Cost CHIP
  • Full-Cost CHIP

Free CHIP is truly free. It does not cost you anything. Low-Cost and Full-Cost CHIP require monthly premiums and copays on some services. Use the income guidelines below to see which CHIP plan you’re eligible for. The covered benefits are the same for all three.

 

Income Guidelines

 

Your household income will determine your out-of-pocket costs.

Download Income Guidelines

 

What do I pay?

 

Once you know which CHIP coverage you’re eligible for, you can use the following charts to estimate your out-of-pocket costs.

 

Monthly Premiums

Program One Child Two Children Three or more Children
Free CHIP $0 $0 $0
Low-Cost CHIP 1 $61.91 $123.82 $185.73
Low-Cost CHIP 2 $86.67 $173.34 $260.01
Low-Cost CHIP 3 $99.06 $198.12 $297.18
Full-Cost CHIP $304.57 $609.14 $913.71
View More Plans View Previous

*Highmark Blue Cross Blue Shield does not increase the monthly premium amount after 3 kids, regardless of how many are in your household.

*Rates effective December 1.

 

Copayments for Visits and Prescriptions

 Program PCP Specialist Emergency Brand Name Drug Generic Drug
 Free CHIP No cost No Cost No Cost No Cost No Cost
 Low-Cost CHIP 1, 2, &3 $5* $10 $25 $9 $6
 Full-Cost CHIP $15 $25 $50* $18 $10
View More Plans View Previous

*No copay required for preventive health services on the Highmark Preventive Schedule. Preventive Schedules are available to Highmark members on their member portal.
Log in to your Highmark account

*Emergency Room copay is waived if admitted.

 

 

Your household income will determine your out-of-pocket costs.

Download Income Guidelines

 

ELIGIBILITY


CHIP Eligibility Requirements

 

  • The child is a Pennsylvania resident
  • The child is not currently enrolled in health care coverage nor are they eligible for Medical Assistance or Medicare
  • The child is under 19 years old
  • The child is a US citizen, a permanent legal alien or a refugee as determined by the US Immigration and Naturalization Service

Please call 1-800-543-7105 for eligibility questions.

 

ENROLL AND RENEW


Want to sign-up for CHIP?

 

There are 3 ways you can enroll or renew:

 

ONLINE

COMPASS Website

You will need to mail in your income verification documents

BY PHONE

Call 1-800-543-7105 to enroll for assistance with paper renewals

BY MAIL
BY MAIL

To enroll:
Fill out the Application form and mail it, along with the other required documents to:

Highmark CHIP
P.O. Box CARING
Pittsburgh, PA 15230-9779

Solicitud para cobertura de atencion medica

SCHEDULE A LEAD SCREENING FOR YOUR CHILD


You children could come into contact with lead from lead paint found in many older homes or from drinking the water out of lead pipes. High levels of lead in the blood can learning problems, slowed growth and aggressive behavior. Children under the age of 6 are at the greatest risk. Luckily, a simple blood test from your doctor can determine if your child’s lead levels are too high. CHIP covers all necessary screenings so schedule an appointment with your doctor today.

HEALTH AND WELLNESS RESORCES


Highmark members have access to a wide variety of resources to help you get healthy, save money and more.

Health & Wellness

Programs, discounts and support you need to live a healthier life.

Health Blog

Health advice, tips, news and more from our team of experts.

Blue 365 Deals

Membership has it’s benefits! Get Discounts on travel, eye glasses, and so much more.

Highmark Healthy YouTube

Watch Videos to help you live your best life.

 

COUNT ON BLUE


When you’re with Highmark, there’s always somebody you can count on anywhere, anytime. Learn more.

Blues on Call

Get 24/7 health support from a Registered Nurse Highmark Health Coach by calling 1-888-BLUE-428.

Telehealth

Video conference consultations with a physician anytime, anywhere - 24/7.

Log In

Log into your Highmark account to check your claims, benefits, provider information, and more.

CHIP Member Handbook

CHIP Member Handbook, Preventive Schedule and Agreement

COMMUNITY PARTNERS


If your organization is interested in partnering with Highmark to help promote the Children’s Health Insurance Program (CHIP), by Highmark providing you with applications and informational brochures to distribute to your clients or at events in your community, please contact:

Aiesha Rashdan, Director, CHIP Program
aiesha.rashdan@highmark.com

 

In the service areas of Western, Northeastern, and Central Pennsylvania, uninsured children and teens under age 19 may qualify for coverage through Pennsylvania’s Children’s Health Insurance Program (PA CHIP) if they are not eligible for Medical Assistance (Medicaid).

In the service area of Delaware, uninsured children and teens under age 19 may qualify for coverage through the Delaware Healthy Children’s Program (DHCP) if they are not eligible for Medical Assistance (Medicaid).

In the service area of West Virginia, uninsured children and teens under age 19 may qualify for coverage through West Virginia’s Children’s Health Insurance Program (CHIP) if they are not eligible for Medical Assistance (Medicaid).