Children's Health Insurance Program
Pennsylvania's Children's Health Insurance Program (CHIP), brought to you by UPMC for Kids, is a state and federally funded program that provides health insurance to eligible uninsured children and teens.
CHIP is available to all uninsured children and teens (up to age 19) regardless of family income. Every uninsured child or teen who is not eligible for Medical Assistance can have comprehensive health insurance with CHIP. Based on a family’s income, children can be enrolled in free CHIP, low-cost CHIP, or full-cost CHIP. Most families are eligible to receive CHIP at no cost, while others with higher incomes will have low monthly premiums and copayments for some services.
Expand All Collapse All
Based on a family's size and income, a child may be eligible if he or she is:
- Under the age of 19
- A U.S. citizen, U.S. National, or Qualified Alien
- A resident of Pennsylvania
- Not eligible for Medical Assistance
Uninsured. Families with annual income above free CHIP limits must show that the child has been uninsured for six months. This does not apply if the child:
- Is younger than age 2; or
- Lost health benefits because a parent lost his or her job; or
- Is moving from another public insurance program; or
- Is eligible for free CHIP (most families qualify for free CHIP).
Children are eligible for free (no cost) CHIP health insurance if the annual family income is no greater than 200% of the Federal Poverty Level (FPL). Children are eligible for low-cost (small monthly payment) CHIP health insurance if the annual income is over 200% and less than 300% of the FPL. Children are eligible for full-cost (larger monthly payment) CHIP health insurance if the annual income is over 300% of the FPL.
For example, a family of four earning $44,101 to $66,150 could be eligible for low-cost CHIP. A family of four earning more than $66,150 could be eligible for full-cost CHIP.
With CHIP, children and teens have access to many great benefits to keep them healthy and help if they are sick or injured. Based on a family's income, copayments may be required for some services.
- Doctor visits, including routine checkups and immunizations
- Diagnostic tests
- Prescriptions and some over-the-counter medications
- Dental care, orthodontia (braces, not for cosmetic reasons, only when medically necessary)
- Vision and hearing services
- Emergency care
- Maternity care
- Mental health and substance abuse services
- Hospital care up to 90 days per year
- Durable medical equipment up to $5,000 per year
- Physical, occupational, and speech therapy
- Home health care
- Tobacco cessation*
- Nutritional counseling*
- Medical nutritional therapy*
* Enhanced benefits that are offered by UPMC for Kids and are not part of the standard CHIP benefit package.
As a UPMC for Kids CHIP member, children have access to our large network of world-class doctors and hospitals. Along with the comprehensive CHIP benefits, we also provide other health and wellness services that can help families maintain a healthy lifestyle. See our member resources for more information about the other services UPMC for Kids provides to CHIP members.
Physicians and Hospitals
Provides a link to help you search online for doctors and hospitals that participate in UPMC for Kids
Provides a list of participating UPMC for Kids mental health and substance abuse providers by county
Provides a link to help you search online for dentists that participate in UPMC for Kids
Provides a link to help you search online for eye doctors that participate in UPMC for Kids
Searchable Pharmacy Directory
Provides a searchable form to locate participating pharmacies by name or location.
Based on your family's income, your child may be enrolled in free, low-cost, or full-cost CHIP, brought to you by UPMC for Kids. Many families will not have to pay for CHIP. Families with higher income will have low monthly premiums and copayments for some services.
Premiums and Copayments
Provides information about copayments and premiums for CHIP, brought to you by UPMC for Kids.
For more information about UPMC for Kids benefits, please visit our Member Materials page.
Click on these links for additional sources of information. These links will take you outside of the UPMC for Kids website.
The Pennsylvania Children's Health Insurance Program (CHIP) website, which provides the history and successes of the program, along with health and wellness information
The Commonwealth of Pennsylvania Access to Social Services website, which allows you to learn more about, apply for, and renew various social services offered by the Commonwealth of PA
Applying for CHIP is easy, and we can help you! Call us at 1-800-978-8762 to apply over the phone or to request a paper application, or you can print an application from our site. TTY users, please call 1-800-361-2629.
You can also complete an application online by using COMPASS, Pennsylvania's fast and easy way to apply for health and human services, at www.compass.state.pa.us.
UPMC for Kids applcation for CHIP health insurance
UPMC for Kids renewal application for CHIP health insurance
Income Guidelines Chart
Family income guidelines used to determine eligibility for CHIP programs