In response to the current public health emergency, the Pennsylvania Children’s Health Insurance Program (CHIP) is making temporary changes to its program requirements. These changes are designed to ease access to CHIP and to keep families enrolled in CHIP for the duration of the public health emergency. The following changes are in effect until the end of the public health emergency:
The following program requirements are still effective:
If you are receiving a request for information, you must still do your best to provide the information to the MCO as requested. You will not be disenrolled from CHIP during the public health emergency for not providing the information, but you will be required to provide it as soon as possible. You must also provide either a signed application, signed renewal or a statement that is signed which attests that the information you are providing is true and correct to the best of your knowledge. Signatures can be electronic or hand-written. You may be asked to provide documentation of information that you self-attested to at the end of the public health emergency.
If you are receiving a request for premium, you still must pay the premium. If you cannot pay the premium on time because your income is decreased or you’ve lost employment, please contact your MCO immediately.
If you did not provide information about your child or children’s date of birth, social security number or tax filing status on an application, you must contact the MCO right away and provide that information. Your application cannot be processed without that information.
If you have any questions about your responsibilities, please contact your MCO at:
PO Box Caring
Pittsburgh, Pa. 15230
Last updated: 4/10/2020
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.
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.
CHIP coverage can be used for the following health services:
View our provider directories, but with less personalization.
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There are three different cost levels of 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.
Your household income will determine your out-of-pocket costs.
Once you know which CHIP coverage you’re eligible for, you can use the following charts to estimate your out-of-pocket costs.
|Program||One Child||Two Children||Three or more Children|
|Low-Cost CHIP 1||$60.14||$120.28||$180.42|
|Low-Cost CHIP 2||$84.20||$168.40||$252.60|
|Low-Cost CHIP 3||$96.23||$192.46||$288.69|
*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 July 1, 2020.
|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|
*No copay required for preventive health services on the Highmark Preventive Schedule. Preventive Schedules are available to Highmark members on their member portal.
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*Emergency Room copay is waived if admitted.
Please call 1-800-543-7105 for eligibility questions.
There are 3 ways you can enroll or renew:
You will need to mail in your income verification documents
Call 1-800-543-7105 to enroll for assistance with paper renewals
Your 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.
You can learn more about the dangers of Lead by selecting this link: EPA Lead Brochure for Children.
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CHIP Member Handbook, Preventive Schedule and Agreement
Medical Policy guidelines for CHIP listed in the Highmark Medical Policy.
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:
Diana Kobus, Director, CHIP Program
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).