CHIP health insurance costs
Free, low-cost, and full-cost CHIP coverage options for your child
CHIP, brought to you by Capital Blue Cross, provides access to health insurance coverage for children in Pennsylvania, regardless of income. We offer flexible CHIP insurance plans that fit your family’s needs and budget.
Depending on your income, your child may qualify for CHIP in one of three ways: free, low cost, or full cost.
What is free CHIP coverage?
Free CHIP coverage is available for families with income that falls within the free CHIP income guidelines. This level of coverage comes with no monthly premium or copays. Families with children on the free CHIP plan pay $0 for doctor visits, prescriptions, dental or vision care, and more.
Visit our CHIP income guidelines to see if you qualify for free CHIP coverage.
Who qualifies for low-cost CHIP coverage?
If your family’s income is above the limits for free CHIP, but is still within CHIP’s limits, you may qualify for low-cost coverage.
Here’s how low-cost CHIP differs from free CHIP:
- You’ll pay a monthly premium based on your income and family size.
- Most services and prescriptions require a small copay. This includes doctor visits, prescriptions, and more.
- Dental, vision, mental health, and hospital services are also covered.
What is full-cost CHIP?
If your income is higher than the limits for free or low-cost CHIP, all families can get CHIP coverage at full cost. What is the difference between full-cost CHIP and other levels of CHIP?
- You pay the full monthly premium.
- Your child receives the same benefits and access to providers as other CHIP members.
- There are no income limits for full-cost CHIP.
Monthly premiums and copays for free, low-cost, and full-cost CHIP
Here’s a quick look at what you may expect to pay for CHIP coverage. Final costs are determined by several factors, including your income.
Free CHIP |
Low-cost CHIP |
Full-cost CHIP |
|
$0 monthly premium |
Average $70-$100 monthly premium |
Average $344 monthly premium |
|
$0 copayments |
Average $5-$25 copayments |
Average $15-$50 copayments |
How do I pay my CHIP premium?
You should pay your CHIP premium on time each month. Late or missed payments may result in the loss of CHIP coverage for your family. If you’re having trouble making your payment or need help with a payment plan, contact us at 800.KIDS.101. We can help keep your child covered. Once enrolled in a low-cost or full-cost CHIP plan, you will receive a monthly premium statement. You can pay your CHIP premium online, set up automatic payments, or pay over the phone.
- Online: Register or log in to your secure account to pay your premium online. You can also use the guest payment option.
- Automatic payments: Sign up for autopay to set up automatic payments from your checking account.
- By phone: Call our automated payment system to make a one-time payment at 855.539.5173
Frequently asked questions about CHIP costs
How much is the monthly premium for CHIP?
The monthly premium for CHIP will vary based on your income and coverage level. If you qualify for no-cost CHIP, you pay nothing. Those who are on low-cost CHIP plans will pay out of pocket for monthly premiums and some services.
Does full-cost CHIP offer the same benefits as free or low-cost CHIP?
Yes. All CHIP members receive the same comprehensive coverage, regardless of the cost they pay.
Are there copays for CHIP coverage?
Yes, but only for low-cost and full-cost CHIP members. Copays on these plans are typically affordable, ranging between $5 and $25 for office visits and common prescriptions.
How do I know what my CHIP cost level will be?
This eligibility is determined during the application process. Your CHIP eligibility will be established once the state reviews your information, including household size and income level.
What happens if I miss a CHIP premium payment?
Missing a payment can put your child’s coverage at risk. Pay your premium on time each month to avoid possible interruptions to your child’s coverage. If you’re struggling to make a payment, contact us for help and we will review your options.
Can I lose CHIP coverage if I forget to pay one month?
If your child is enrolled in low- or full-cost CHIP, you must make your first premium payment to ensure their coverage. After the first payment, low-cost CHIP members will remain enrolled even if you miss a payment. However, full-cost CHIP members will lose coverage if they do not make monthly payments.
It’s important to keep your account current. You can call us at 800.KIDS.101 to ask for assistance before the due date if you think you might miss a payment.