Frequently Asked Questions

Applying and Eligibility

What is CHIP?

CHIP is short for the Children’s Health Insurance Program. CHIP is a state and federally funded program that provides comprehensive health insurance to uninsured children and teens up to age 19 who are not eligible for Medical Assistance. If you know a child who needs health insurance, CHIP, brought to you by UPMC for Kids, can help.

Who gets CHIP coverage?

Uninsured children (younger than 19 years old) who are not eligible for or enrolled in Medical Assistance can receive coverage. You can learn more on our Eligibility page.

Can I make too much money to enroll my child with CHIP?

No. Your child can still be enrolled with CHIP program no matter how high your family income. However, if your income is found to be below the income guidelines for the CHIP program, your child’s application may be referred to Medical Assistance.

Are children with pre-existing conditions eligible?

Yes. There are no exclusions for pre-existing conditions in CHIP or Medical Assistance. However, if your child has a serious medical condition or disability, he or she may be considered by Medical Assistance.

If my child has health insurance through my employer, can I still get CHIP?

No, children cannot have any other health insurance to enroll in CHIP. If your child is enrolled in CHIP coverage and gains private insurance, contact us right away at 1-800-650-8762.

Whose income should I include on the application?

CHIP has rules about who is included when determining eligibility. Give information, including income, for anyone who lives with you. Also, anyone whom you expect to be included on your tax return—even if they do not live with you. For more information, call UPMC for Kids at 1-800-978-8762.

How can I check the status of my application?

If you would like to check the status of your application, you can call us at 1-800-978-8762, Monday through Friday from 8 a.m. to 7 p.m. TTY users should call 711.

Does CHIP have a waiting list?

No. There is no waiting list to enroll in CHIP.

How long do children stay covered?

If children continue to meet CHIP’s eligibility requirements, they can be covered up to age 19. Eligibility is reviewed once a year during renewal.

What is the UPMC for Kids service area?

We serve 41 counties in Pennsylvania. View our Eligibility page to see if UPMC for Kids provides coverage in your area.

Renewing Coverage

How can I renew coverage?

Ready to renew UPMC for Kids coverage for your child? Call us at 1-800-978-8762, and we can help you get started. To apply online or complete a paper renewal, visit our How to Renew page.

Where can I send my renewal or income documentation?
  • Online: Complete all required fields on the CHIP Documentation Submission Form and attach the documents using this secure website.
  • Fax: 412-454-5937
  • Mail: UPMC for Kids, PO Box 2875, Pittsburgh, PA 15230
How can I check the status of my renewal?

When the renewal is completed, you will be notified by mail. If you would like to check the status, you can call us at 1-800-978-8762, Monday through Friday from 8 a.m. to 7 p.m. TTY users should call 711.

Benefits

What does UPMC for Kids cover?

UPMC for Kids includes medical, dental, vision, prescription, and behavioral health coverage. For more details, you can visit our Benefits page.

Does UPMC for Kids cover emergencies?

With UPMC for Kids, your child is covered for emergencies at any hospital within the United States. You do not need to pay a copay if your child is admitted to the hospital.

How do I order a new or duplicate ID card?

There are several ways that you can request a new ID card.

  • Online: Log in or register for MyHealth OnLine to print a temporary copy of your child’s ID card from home, and chat with a representative to request a new card.
  • Call: Call us at 1-800-650-8762. Representatives are available Monday through Friday from 7 a.m. to 7 p.m. and Saturday from 8 a.m. to 3 p.m. TTY users should call 711.
How do I update my child’s Primary Care Physician (PCP?)

If you’d like to update your PCP, you can contact the UPMC for Kids Health Care Concierge team by calling 1-800-650-8762. Once it is updated, you will receive a new member ID card in the mail with the updated PCP group name.

Premiums

Will I need to pay a monthly premium for my child’s coverage?

Based on family income, your child may be enrolled in free CHIP, low-cost CHIP, or full-cost CHIP. Most families are eligible to receive CHIP at no cost. Families with higher incomes will have low monthly premiums and copayments for some services. Families with incomes below the CHIP threshold may be eligible for Medical Assistance.

Visit our Eligibility page to learn more about CHIP income guidelines and premium rates in your area. You can also call us at 1-800-978-8762, and we’d be happy to assist you.

How can I make payments?

You can pay premiums online by logging in or registering for MyHealth OnLine. You can also call 1-800-650-8762 to use our secure automated system to pay over the phone 24/7.

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