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Individual & Family Products

Premiums & Copayments

CHIP Premium

The Commonwealth of Pennsylvania and the Federal Government pay a portion of the eligible child's monthly premium. Capital BlueCross also subsidizes* a portion of that monthly premium.

CHIP has expanded to cover all uninsured children and teens (up to age 19) who are not eligible for Medical Assistance. Your household income will determine if the coverage is free or offered at a low cost. Below is a chart to show how affordable the coverage is through CHIP, brought to you by Capital BlueCross:

Premium rates effective December 1st, 2016

Program Monthly Premium Per Child
Low Cost CHIP Program 1 $55.00
Low Cost CHIP Program 2 $70.00
Low Cost CHIP Program 3 $80.00
Full Cost CHIP $295.08

*The amount which is subsidized by Capital BlueCross is subject to review on a yearly basis. This means that the portion of the premium for which the parent is responsible is subject to change.

Make CHIP premium payments automatically from your bank with our new Check It Out®program. There is no charge to you and premium payments will be automatically deducted from your bank account each month.

Find out more and print an enrollment form for Check It Out

Families whose household income is within the Low Cost and Full Cost CHIP income ranges will have modest copayments for covered services. The chart below shows the copayments for services:

Services Low Cost CHIP Programs Full Cost CHIP
Doctor Visits $5 (Except for well-child visits) $15.00
Specialist Visits $10 $25.00
Emergency Room** $25 $50.00
Brand-Name Prescription $9 $18.00
Generic Prescription $6 $10.00

**Emergency room visit co-pay applies if the child is not admitted for a hospital stay. Find out more about emergency and urgent care

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