Inpatient hospital admissions (in 11 states)ĬHIP families in cost-sharing states paid an average monthly premium of $18 to $25 per child in 2018. Generic prescription medications (in 12 states) Nonpreventive physician visits (in 16 states) As of January 2020, Medicaid/CHIP enrollees with income at 151% of the federal poverty level can expect cost sharing for: However, your state may charge a copayment for certain services depending on your income. Some CHIP benefits, such as well-child doctor visits and dental visits, are free. States that have Medicaid-expansion CHIP programs abide by Medicaid’s rules on premiums and cost-sharing. Wisconsin provides special services for children on CHIP who have moderate to severe asthma.ĬHIP is not entirely free, but the cost is modest. Hawaii CHIP establishes school-based vision-screening programs. Through Medicaid, Maine has free tobacco-prevention and -cessation programs. Kids and adolescents can receive treatment for mental health conditions - including substance use - with CHIP.īeyond federal coverage, some states provide additional services. Some states with separate CHIP programs have EPSDT or similar coverage.Īll state Medicaid programs cover essential outpatient and inpatient mental health services. This includes developmental and health services. Medicaid expansion states cover the Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) benefit for children. Many states cover them without limitation. Routine checkups (well-baby and well-child visits)Īll states cover medically necessary physical, occupational, and speech and language therapy for Medicaid-eligible people. What standard benefits does CHIP cover?įederal law has coverage standards for states’ Medicaid-expansion CHIP programs. In short, these plans can vary, so it’s important to read policy documents carefully to make sure the coverage fits your child’s needs. Separate CHIP programs may have coverage waiting periods and higher premiums than state Medicaid. Why this matters: Medicaid expansion CHIPs follow federal Medicaid rules, but a state with separate or combination CHIP is less bound by federal requirements and can design and operate its program independently. It may be a separate CHIP, a CHIP that expands Medicaid, or a combination CHIP. Also like Medicaid, a state’s CHIP may be administered by its government or by a managed care organization.Ī 1997 federal law mandates that each state or territory must have a CHIP (though it may be called by another name). Generally, the federal government covers about 70% of the funding. Like Medicaid, CHIP is a federal-state partnership. What is the Children’s Health Insurance Program (CHIP)?ĬHIP provides free or low-cost health insurance for kids in households with slightly too much income for Medicaid eligibility. Here’s an introduction to this family-friendly insurance program. Of the nation’s 13.9 million children with special needs, more than 40% are insured through Medicaid/CHIP. About 25% of children enrolled in CHIP have a chronic health condition nearly 12% have asthma. In fact, CHIP or Medicaid insure 25% or more of the children in these 12 states:Īccording to the Modern Medicaid Alliance, CHIP and Medicaid insure about 1 in 3 children in the U.S. get health coverage from the Children’s Health Insurance Program (CHIP), an offshoot of Medicaid. More than 9 million kids and teens across the U.S.
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