Eligibility

For most families, CHIP is free. A household with income above a certain level can receive CHIP at low-cost or full-cost.

Boy with a frog

Key requirements

To qualify for CHIP, your child must be:

  • under the age of 19
  • a resident of Pennsylvania
  • a U.S. citizen, a lawfully admitted alien with permanent status or a refugee as determined by U.S. Immigration and Naturalization Services
  • uninsured and not eligible for or enrolled in Medical Assistance

Family of four CHIP income limits and eligibility:1

  • free coverage if you earn up to $54,496
  • low-cost coverage if you earn up to $68,644
  • full-cost coverage if you earn more than $82,2682

CHIP eligibility guidelines

Check out our listings to see if you are eligible for free or low-cost coverage.

  1. Locate the number of people in your household.
  2. Find the box that matches your household's annual gross income and age of your children.
  3. Look down the column to see your monthly cost per child and the copay per child, per visit.

Example: A four-person household with an annual income of $69,840 will pay a monthly premium of $70 per child, plus any copay for services.

Household size

Income level 
ages 1-5

Income level 
ages 6-18

1 $ 20,222  $ 26,791 $ 17,131  $ 26,791
2 $ 27,350  $ 36,234 $ 23,169  $ 36,234
3 $ 34,478  $ 45,677 $ 29,207  $ 45,677
4 $ 41,605  $ 55,120 $ 35,245  $ 55,120
5 $ 48,733  $ 64,564 $ 41,284  $ 64,564
6 $ 55,861  $ 74,007 $ 47,322  $ 74,007
7 $ 62,989  $ 83,450 $ 53,360  $ 83,450
8 $ 70,117  $ 92,893 $ 59,398  $ 92,893
9 $ 77,244  $ 102,336 $ 65,436  $ 102,336
10 $ 84,372  $ 111,780 $ 71,475  $ 111,780
11 $ 91,500  $ 121,223 $ 77,513  $ 121,223
12 $ 98,628  $ 130,666 $ 83,551  $ 130,666
13 $ 105,756  $ 140,109 $ 89,589  $ 140,109
14 $ 112,883  $ 149,552 $ 95,627  $ 149,552
15 $ 120,011  $ 158,996 $ 101,666  $ 158,996
16 $ 127,139  $ 168,439 $ 107,704  $ 168,439
17 $ 134,267  $ 177,882 $ 113,742  $ 177,882
18 $ 141,395  $ 187,325 $ 119,780  $ 187,325
19 $ 148,522  $ 196,768 $ 125,818  $ 196,768
20 $ 155,650  $ 206,212 $ 131,857  $ 206,212
+Person $ 7,128  $ 9,444 $ 6,039  $ 9,444

Household size

Subsidized coverage 1 
Income level 
Ages 0-1

Subsidized coverage 1 
Income level 
Ages 1-18

Subsidized coverage 2 
Income level 
Ages 0-18

Subsidized coverage 3 
Income level 
Ages 0-18

1

$ 27,692  $ 33,746 $ 26,791  $ 33,746 $ 33,746  $ 37,095 $ 37,095  $ 40,444
2 $ 37,453  $ 45,641 $ 36,234  $ 45,641 $ 45,641  $ 50,170 $ 50,170  $ 54,699
3 $ 47,214  $ 57,536 $ 45,677  $ 57,536 $ 57,536  $ 63,245 $ 63,245  $ 68,955
4 $ 56,975  $ 69,430 $ 55,120  $ 69,430 $ 69,430  $ 76,320 $ 76,320  $ 83,210
5 $ 66,736  $ 81,325 $ 64,564  $ 81,325 $ 81,325  $ 89,396 $ 89,396  $ 97,466
6 $ 76,497  $ 93,220 $ 74,007  $ 93,220 $ 93,220  $ 102,471 $ 102,471  $ 111,722
7 $ 86,258  $ 105,115 $ 83,450  $ 105,115 $ 105,115  $ 115,546 $ 115,546  $ 125,977
8 $ 96,019  $ 117,010 $ 92,893  $ 117,010 $ 117,010  $ 128,621 $ 128,621  $ 140,233
9 $ 105,780  $ 128,904 $ 102,336  $ 128,904 $ 128,904  $ 141,696 $ 141,696  $ 154,488
10 $ 115,541  $ 140,799 $ 111,780  $ 140,799 $ 140,799  $ 154,772 $ 154,772  $ 168,744
11 $ 125,302  $ 152,694 $ 121,223  $ 152,694 $ 152,694  $ 167,847 $ 167,847  $ 183,000
12 $ 135,063  $ 164,589 $ 130,666  $ 164,589 $ 164,589  $ 180,922 $ 180,922  $ 197,255
13 $ 144,824  $ 176,484 $ 140,109  $ 176,484 $ 176,484  $ 193,997 $ 193,997  $ 211,511
14 $ 154,585  $ 188,378 $ 149,552  $ 188,378 $ 188,378  $ 207,072 $ 207,072  $ 225,766
15 $ 164,346  $ 200,273 $ 158,996  $ 200,273 $ 200,273  $ 220,148 $ 220,148  $ 240,022
16 $ 174,107  $ 212,168 $ 168,493  $ 212,168 $ 212,168  $ 233,223 $ 233,223  $ 254,278
17 $ 183,868  $ 224,063 $ 177,882  $ 224,063 $ 224,063  $ 246,298 $ 246,298  $ 268,533
18 $ 193,629  $ 235,958 $ 187,325  $ 235,958 $ 235,958  $ 259,373 $ 259,373  $ 282,789
19 $ 203,390  $ 247,852 $ 196,768  $ 247,852 $ 247,852  $ 272,448 $ 272,448  $ 297,044
20 $ 213,151  $ 259,747 $ 206,212  $ 259,747 $ 259,747  $ 285,524 $ 285,524  $ 311,300
+Person $ 9,761  $ 11,895 $ 9,444  $ 11,895 $ 11,895  $ 13,076 $ 13,076  $ 14,256

Household size

Income level 
ages 1-18

1 $ 40,444  No limit
2 $ 54,699  No limit
3 $ 68,955  No limit
4 $ 83,210  No limit
5 $ 97,466  No limit
6 $ 111,722  No limit
7 $ 125,977  No limit
8 $ 140,233  No limit
9 $ 154,488  No limit
10 $ 168,744  No limit
11 $ 183,000  No limit
12 $ 197,255  No limit
13 $ 211,511  No limit
14 $ 225,766  No limit
15 $ 240,022  No limit
16 $ 254,278  No limit
17 $ 268,533  No limit
18 $ 282,789  No limit
19 $ 297,044  No limit
20 $ 311,300  No limit
+Person $ 14,256  No limit

If your income is below any amount listed, your child could be eligible for Medical Assistance. For more details, please call 800.543.7101.


1 Dependent on your income, your child may be enrolled in Medical Assistance. Commonwealth of PA guidelines require weekly wages to be calculated at 48 payments and biweekly wages to be calculated at 24 payments.

2 You must make more than $82,268 to be eligible for the full cost program.

Income guidelines according to the January 13, 2021, Federal Register. FPIG's are effective for CHIP for March 1, 2021.

The bottom income limit for CHIP forms the upper income limit for Medicaid. The Affordable Care Act permits an income disregard of 5% of the upper Medicaid limit for applicants with incomes near the limit. This provision could result in some CHIP applicants being referred to the Department of Public Welfare if the household income is near the upper Medicaid limit.

CHIP coverage is issued by Keystone Health Plan® Central through a contract with the Commonwealth of Pennsylvania. Blue Cross Dental℠ and Blue Cross Vision℠ are issued by Capital Advantage Assurance Company®. Capital Advantage Assurance Company and Keystone Health Plan Central are subsidiaries of Capital Blue Cross. All are independent licensees of the Blue Cross Blue Shield Association. Communications are issued by Capital Blue Cross in its capacity as administrator of programs and provider relations.