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CHIP Overview | Coverage | Costs | Enroll | Covered Doctors & Facilities | Health & Wellness | Count On Blue
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.
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
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.
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
*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 |
*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.
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.
Want to sign-up for CHIP?
There are 3 ways you can enroll or renew:
BY PHONE
Call 1-800-543-7105 to enroll for assistance with paper renewals
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
SCHEDULE A LEAD SCREENING FOR YOUR CHILD
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.
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.
- For CHIP Parents/Guardian of members 12 years and younger, go to https://www.sharecare.com/ and select Get Started to setup an online account
- For CHIP members 13 years and older, go to https://mycare.sharecare.com/ and select Create an Account.
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.
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).
