CHIP frequently asked questions

Applying

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 year old
    • anyone you include on your tax return, including those who don’t live in the household

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 

How soon will I be notified after you receive my child’s application?

Allow three to four weeks for your application to be processed and notification to be sent.

Must children be uninsured for six months before applying?

If a child has no insurance, they may apply for CHIP immediately. If a child’s health insurance is ending, you may apply for CHIP before the end date by submitting a certificate of credible coverage with the application as proof of the termination date.

When can I apply for CHIP for my unborn baby?

You must wait to apply until the child is born. A social security number is not needed to initially apply but must be added to your application once available.

If I am not a US citizen, but my child is, may I apply for CHIP for my child?

Yes, the citizenship status of the parent does not affect CHIP eligibility. A child must be a citizen of the United States, a U.S. National or a lawfully-residing resident as determined by the United States Citizenship and Immigration Services.

Include the acceptable proof of citizenship and identity documentation with your application.

Eligibility

Is there CHIP coverage for adults?

CHIP is only for uninsured children up to age 19. Adults can apply for health insurance with Capital Blue Cross or through Pennie.

If I enroll in a health insurance plan through my employer, do I have to remove my child from CHIP?

Your child may remain on CHIP as long as the child was not enrolled in your employer health insurance. If you enrolled your child in your employer health insurance your child must be removed from CHIP.

What are the income requirements and costs for CHIP?

See our income eligibility guidelines and program costs.

Can I get portions of this coverage that are not covered under my own health insurance?

No. CHIP coverage cannot be used with any other health insurance plan.

I live in another state. Can I get coverage for my children with CHIP through Capital Blue Cross?

No. Our CHIP plans are only available to residents living in the Capital Blue Cross service area.

Is grandparent's income used to determine CHIP income eligibility?

Grandparent’s income is only used if the grandparent has custody or guardianship of the CHIP member(s).

May a child have other insurance coverage and remain on CHIP?

No other medical coverage is allowed. A child may have a stand-alone dental and/or vision plan. If this is the case, CHIP dental and/or vision coverage will be considered secondary insurance coverage.

Does CHIP offer guest membership for CHIP members?

Yes. Guest membership is only available for detached families and students. The guest membership only applies if the child will be out of the area for 3-6 months.

Are children’s Social Security benefits used to determine income for CHIP applications or renewals?

Social security benefits of children are not counted when determining eligibility for CHIP unless the child has other income requiring them to file a tax return.

What documentation is needed when a parent has started a business but has not yet filed their income taxes?

A profit/loss statement must be submitted for the period that the business has been active.

Include the acceptable proof of income documentation with your application.

May a social security card be used to document citizenship?

No. Refer to the acceptable proof of citizenship and identity page for more information.

Does CHIP coverage continue beyond the age of 19?

No, CHIP coverage ends at the end of the month of the child’s 19th birthday.

My child is 18 and will be attending college in the fall. Can my child stay enrolled in CHIP while going to school in another state?

Families apart
  • CHIP members are eligible for limited families apart type guest memberships.
  • As long as the CHIP member resides with the CHIP head of household (HOH) for a minimum of 6 months in a year, the HMO residential requirements are met.
  • The specific guest membership start and stop dates are required for CHIP members who request this type of guest membership.
  • Guest membership only applies if the child will be out of the area for a period of at least 90 days but not more than 180.
Students
  • HMO residential requirements for CHIP members are met by the HOH. Note: Technically CHIP students still reside within our coverage area, and as such are eligible for student type guest membership.
  • This is available to:
    • college students
    • boarding school students
    • grade school students
  • As long as the CHIP HOH resides within the KHP Central service area, this type of guest membership can be maintained.

Can I appeal if CHIP says I’m ineligible?

If you do not agree with the eligibility decision, you may submit a written request for an impartial review within 30 days from the date on your decision letter.

Send us your eligibility review request and relevant documents.
  • Email us an appeal request
  • Fax us the appeal request: 717.651.8592.
  • Or mail us the appeal request: 
    Capital Blue Cross

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

We may contact you for more information. If we cannot resolve your issue, we will forward your written request and any additional information to the Pennsylvania Insurance Department. You may receive more detailed information from the Pennsylvania Insurance Department, including the time and date that a phone interview will be held, if needed.

Using your coverage

When searching for a provider, what plan should I choose?

Use MyCare Finder and choose "CHIP Network". By starting with CHIP, the CHIP providers will have a PromiseID.

When searching for a dentist, what plan should I choose?

Use MyCare Finder and choose "Blue Cross Dental PPO (CHIP members)". By starting with CHIP, the CHIP providers will have a PromiseID.

How do I change my child’s Primary Care Physician (PCP)?

Call Member Services at 800.KIDS.101 to change your child's PCP.

May a CHIP member register a secure account to view benefit information?

Parents and guardians can register a secure account for CHIP members to view and manage the benefit plan.

Parents with more than one child enrolled in CHIP coverage will need a unique email address for each child to be registered.

May a child’s head of household (HOH) make an initial payment using the automated IVR system?

Yes, you may make your child’s initial premium payment through the IVR. However, please note that if you have more than one child, you will need to make separate payments for each child.

What is the PH95 Loophole Program?

PH95 is a program through the Department of Public Welfare allowing Medical Assistance coverage for children under 18 with a severe disability, Autism Spectrum Disorder or a behavioral disorder regardless of the parents’ income.

If a child qualifies for Medical Assistance under the PH95 loophole must they move to the Medical Assistance program and terminate their CHIP coverage?

Yes, if the child qualifies under the PH95 program the parent must move to Medical Assistance.

Renewing your coverage

How soon will I be notified after you receive my child’s renewal?

Allow three to four weeks for your application or renewal to be processed and notification to be sent.

Are children’s Social Security benefits used to determine income for CHIP renewals?

Social security benefits of children are not counted when determining eligibility for CHIP unless the child has other income requiring them to file a tax return.

Once enrolled, is there any further action a head of household (HOH) must take to keep their child’s CHIP coverage?

The HOH must renew a child’s CHIP coverage each year. If we do not receive the renewal form before the deadline, your child’s coverage will expire. You’ll receive renewal information 120 days prior to your child’s anniversary date.