Questions and Answers
Here are some questions and answers that may be helpful for families applying for low- cost or no-cost health insurance for their children and teens.
- About CHIP and Medicaid
- Why is health insurance so important
- Eligibility Information
- Covered Services
- Costs for Families
- Application Process and Additional Information
Q: I need health insurance for my children and teens. Are they eligible for Medicaid or CHIP?
A: States have different income eligibility, but in most states, uninsured children 18 years old and younger whose family incomes are up to $45,000 per year (for a family of four) can qualify for either Medicaid or CHIP. In many States, family income can be even higher and children can still qualify.
Call 1-877 KIDS NOW (1-877-543-7669) or go to Programs in Your State to find state-specific information about Medicaid and CHIP. When you call our free and confidential hotline, you will be directly connected to your State's programs. Staff can help you learn whether your children might qualify and help you enroll them.
Q: Is this program new?
A: No. Medicaid has been available since 1965 and CHIP since 1997. In February 2009 and March 2010, President Obama signed legislation that provided additional new funding for the Medicaid and CHIP programs, with a special focus on enrolling eligible but unenrolled children. States have expanded and changed their programs over the years, and in many cases, it is easier than ever to apply for Medicaid and CHIP.
Q: Why is health insurance for children and teens important?
A: Children who have health insurance generally have better health throughout their childhood and into their teens. They are less likely to get sick and more likely to:
- get preventative care to keep them well;
- get the treatment they need when they are sick or injured;
- receive needed shots that prevent disease;
- get treatment for recurring illnesses such as ear infections and asthma; and
- get dental care;
- over five times more likely to have an unmet need for medical care;
- over three times more likely not to get a needed prescription drug;
- much less likely to receive preventive services including immunizations, dental and vision care and medical care for conditions such as sore throats, ear infections and asthma;and
- 30% less likely to receive medical treatment if they are injured.
Q: How can insurance help my children and teens stay healthy?
A: You'll be able to pick a doctor for your children so they can get the health care they need when they need it. With health insurance, your child will be able to get immunizations and well-child visits required to attend school and often required to play sports. If your child gets sick, you can get prescription medicines to help him or her get better fast.
Q: How can health insurance help my child's and teen’s ability to learn?
A: Children with health insurance are less likely to miss school because they are sick. Students who are feeling healthy have an easier time focusing on their school work.
Q: Who is eligible for Medicaid or CHIP?
A: States have different income eligibility rules, but in most States, children under age 19 with family income up to $45,000 per year (for a family of four) may qualify for either Medicaid or CHIP. In many States, family income can be even higher and children can still qualify.
Q: I have teenagers. Are they eligible, too?
A: Yes, in every State, children from birth until their 19th birthday whose family income is up to $45,000 per year (for a family of four) may be eligible. In many States, family income can be even higher and children can still qualify. To find State-specific information about Medicaid and CHIP programs, go to About Your State Programs.
Q: I have a job. Can my children and teens still qualify?
A: Yes, most children who are eligible for Medicaid and CHIP but are not enrolled are in working families. Working parents may not have health coverage through their jobs or the health coverage they get does not cover their children. Many working families cannot afford health insurance on their own. To find out if your children may be eligible, call 1-877 KIDS NOW (1-877-543-7669) or go to About Your State Programs to find your State’s program.
Q: Who can apply for health insurance for my child or teen?
A: Parents, grandparents, and legal guardians can apply for Medicaid and CHIP on behalf of a child. Call 1-877 KIDS NOW (1-877-543-7669) or go to Programs in Your State to find out the rules for your State. Your call will be free and confidential.
Q: Is there a limit on the amount of time my child or teen can remain enrolled in Medicaid or CHIP?
A: Children and teens can stay covered as long as they qualify. Although there is no limit on the amount of time your children can remain in the program, you will need to renew their coverage periodically, typically once a year in most States. The program will contact you to let you know that it is time to renew your child’s coverage.
Q: What if my children and teens are covered by Medicaid or CHIP already?
A: Congratulations, they already have comprehensive health insurance. If you are having trouble seeing a doctor or getting a needed service, call the toll free number 1-877 KIDS NOW (1-877-543-7669).Remember to renew your child’s coverage when it’s time, usually one year after your child gets enrolled.
Q: What services does Medicaid and CHIP cover?
A: Medicaid and CHIP pay for doctor visits, immunizations, dental care, prescription medicines, hospital care, and much more. Click on Programs in Your State to visit your State’s web site and find out more.
Q: Is the flu vaccine covered?
A: Yes. Flu vaccines are covered for people with Medicaid/CHIP. For more information about the flu and the flu shot, visit http://www.cms.gov/immunizations/
Q: Who pays for the health insurance coverage under Medicaid and CHIP?
A: Depending on their income, many families will get health coverage for their children and teens at no cost. Other families may be required to pay modest enrollment fees, premiums, and copayments. The rest of the coverage is paid for by the Federal government and your State.
Q: How can I get more information on my state's program?
A: To find state-specific information about Medicaid and CHIP go to Programs in Your State or call 1-877 KIDS NOW (1-877-543-7669) to be connected directly to your State’s program. The call is free and confidential.
Q: How do I apply?
A: The first step is to call 1-877 KIDS NOW (1-877-543-7669) to be connected directly to your State’s program or go to www.insurekidsnow.gov and click on Programs in Your State. Depending on the State, families can apply in person, by mail, over the phone and even on-line. Community organizations in many States are standing ready to help.
Q: I'm not applying for this program, but I'd like to get involved. How can I help?
A: To help other families learn more about available health insurance for their children, go to the Programs in Your State for more information. If your organization wants to help connect kids to coverage by stepping up to the challenge of enrolling five million uninsured kids in Medicaid or CHIP, visit Connecting Kids to Coverage Challenge to learn more.