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. Once submitted, the application is sent to Capital Blue Cross immediately.

Other ways to apply

Email us to request a application or print out the CHIP application in English or Spanish. Send us your completed application and relevant documents.

  • 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