What is Medicaid? What is CHIP? Eligibility and Coverage

Medicaid and CHIP eligible people

Medicaid and CHIP are joint state and federal programs that provide health coverage at low and even free cost to millions people (families, pregnant women, children, those with disabilities and the elderly). Medicaid is available since 1965 and CHIP programs started in 1997. Recently, thanks to President Obama, these programs get their funding increased since 2010, with emphasis on the enrollment of children who are eligible but are not enrolled. Through the years, Medicaid and CHIP have positively evolved in the states and it is mostly now easier to apply.

Medicaid eligibility

All states provide Medicaid to infants and children under age 6 with family incomes up to 133% of the federal poverty level, or FPL ($29,725 for a family of four in 2011). Medicaid is available in all states for children under age 19 with family incomes up to $ 22,350 (100% FPL). Medicaid covers US citizens and eligible immigrants.
In some states, children are eligible for Medicaid if their family incomes are higher. Learn more about Medicaid and other programs in your state website.

CHIP eligibility

Children’s Health Insurance Program or CHIP covers children at low cost when their family is higher than the maximum allowed to qualify for medicaid. The states have different rules for income eligibility, usually children under age 19 with family income over $ 45,000 per year (for a family of four). In many states, the family income may be even greater for children to qualify.

Covered services

Q. What services does Medicaid or CHIP cover?

A. Medicaid and CHIP cover a complete set of services, including preventive care, immunizations, medical examinations and treatment of medical conditions, visits to doctors and hospitals, dental and vision care. Flu vaccines are also covered for people with Medicaid / CHIP.

Costs for families

Q. Who pays for health insurance coverage under the Medicaid and CHIP programs?

A. Depending on their income, many families will receive health coverage for their young children and adolescents at no cost. Possibly, other families will pay modest registration fees, premiums and co-payments. The rest of the coverage is paid by the federal government and the state.

What make health insurance so important for children and adolescents?

Children who are insured tend to enjoy better health during childhood and early adolescence. They are less likely to get sick and are more likely to:
– get regular care to prevent conditions and stay healthy;
– get in time all necessary treatment in case of sickness or injury;
– receive the necessary vaccines for disease prevention;
– receive medical care to treat recurring conditions, for example asthma and ear infections;
– get dental care;

At the opposite, uninsured children:
– are three times more likely not to receive in time the prescription drugs they need;
– usually will not get preventive care such as immunizations, vision and dental care, as well as medical care for recurring conditions ( asthma, ear infections and sore throats);
– are three times less likely to receive treatment in case of injury.

Children with health insurance are less likely to miss school due to illness. Healthy students have less difficulty concentrating on the study.