CHIP: The Children’s Health Insurance Program

Are your clients over-qualified for Medicaid but struggling to afford health insurance? The Children’s Health Insurance Program (CHIP) might be an option.

A Brief History of the Children’s Health Insurance Program (CHIP)

The Children’s Health Insurance Program (CHIP) originated as SCHIP (State Children’s Health Insurance Program) by the Balanced Budget Act of 1997 to provide assistance to those who were over-qualified for Medicaid but still could not afford health insurance for their children. The Patient Protection and Affordable Care Act of 2010 extended the authorization of the federal CHIP program through September 30, 2015. After being funded by Congress again in 2015, funding is now set to expire in September 2017, but CHIP is still a viable option for those in need of finding health care coverage for their children.

CHIP in California

Each state can design and structure a separate CHIP program within its Medicaid system. They can also combine programs. CHIP currently funds eight coverage programs for children and women, per the California Healthcare Foundation. California Medicaid programs are collectively known as Medi-Cal and have a variety of eligibility standards. 

In 2014, the participation rate of eligible children in California was 92.3%, slightly higher than the national average, according to the National Academy for State Health Policy.

Currently, there are no limited enrollment periods in California for CHIP, which means now is a good opportunity to spread the word and help families get coverage under the CHIP program.

CHIP Benefits

Some of the benefits available through CHIP coverage include the following:

  • Routine Check-Ups
  • Immunizations
  • Doctor Visits
  • Prescriptions
  • Dental and Vision Care
  • Inpatient and Outpatient Hospital Care
  • Laboratory and X-Ray Services
  • Emergency Services
  • Conception to Birth Coverage

Who Qualifies for CHIP?

As cited by The Kaiser Commission, approximately 5 million children are uninsured in the U.S. But it is estimated that nearly 65% of those children are eligible for CHIP or Medicaid. Making families aware of their options and what qualifies them for assistance is key.

CHIP eligibility is based on modified adjusted gross income (MAGI), and in some areas of California eligibility can be up to 317% of the Federal Poverty Level (FPL). Coverage premiums are generally $13 per child and no more than $39 per household. In some cases, there are no premiums based on the percentage of the FPL of the household.

CHIP also covers conception to birth under the unborn child option. There are four ways to apply:

  • Online
  • By phone
  • In person
  • A paper application

Want to Learn More About CHIP Enrollment and Eligibility?

As a broker in the Bay Area, you can guide your clients through the process of discovering what health coverage options they have available to them. Healthy kids and strong families create a brighter future for our country and our communities. The American Academy of Pediatrics explains, “Promoting healthy children, supporting secure families, building strong communities, and ensuring the United States is a leading nation for children,” are key elements, “critical for the future of our country.” Brokers can have an influential role in helping secure that future.


California: 2016 CHIP fact sheet. (2016). National Academy for State Health Policy. Retrieved from

Children’s Health Insurance Program overview. (2015, April 17). National Conference of State Legislatures. Retrieved from

Cornachione, E., Rudowitz, R., & Artiga, S. (2016, June 27). Children’s health coverage: The role of Medicaid and CHIP and issues for the future. The Henry J. Kaiser Family Foundation. Retrieved from

Dreyer, B. P., Stein, F., & Remley, K. (2016, December). How the next president can build a foundation for a healthy future: Improving children’s lives. Pediatrics. Retrieved from

Lewit, Eugene. (2015, May). Two more years: What does continued CHIP funding mean for California? California Health Care Foundation. Retrieved from

The Children’s Health Insurance Program (CHIP). Retrieved from