Apply for CHIP

There are multiple ways to apply for coverage. Let us help.

Boy playing with a frog.

How do I complete the application?

  • Complete one application for all children living in the household that are under 19 years old whether you are applying for them or not
  • Answer all of the questions completely or it will delay processing your application
  • Include your acceptable proof of income and acceptable proof of citizenship and identity documentation
  • Include other documentation noted on the application
  • Include these individuals on your application:
    • yourself
    • your spouse or unmarried partner
    • anyone living in the household that are under 21 years old
    • anyone you include on your tax return, including those who don’t live in the household

Apply online

COMPASS walks you through the steps to complete an application, including what documentation is needed. When you choose Capital Blue Cross in the Insurance Company Information section, the application is sent to immediately for processing.

Other ways to apply

Request an application by email or call 800.543.7101 and request a COMPASS callback. A CHIP team member will call you back to complete a COMPASS application on your behalf.

You can also print out the CHIP application in English or Spanish and send us your completed application and relevant documents by one of the following options:

  • Email us the completed application
  • Fax us the completed application: 717.651.8592
  • Or mail us the completed application:
    Capital Blue Cross

    PO Box 777014 
    2500 Elmerton Avenue 
    Harrisburg, PA 17177-7014