What information do you need for a CHIP application form?


Quick Answer

As of 2015, general information required to complete a Children's Health Insurance Program, or CHIP, application may include household size, family status and income, according to Healthcare.gov. Each state may require additional information, as eligibility requirements differ by state.

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Full Answer

Determine eligibility and review specific state requirements at Insurekidsnow.gov. Select the state from the drop down menu, or click on the state using the interactive map, instructs the website. Alternatively, click the List of States link located at the bottom of the homepage, and select the state from the list.

CHIP is a federal program that provides low-cost medical coverage to children whose families earn too much to qualify for Medicaid, explains Healthcare.gov. CHIP health care coverage is offered in each state, and the program is closely aligned with Medicaid.

Enrollment into CHIP is year-round with no specific enrollment period, states Healthcare.gov. In many states, if a parent qualifies for Medicaid, the children automatically qualify for CHIP or Medicaid.

Benefit coverage differs by state, but all states offer basic comprehensive coverage, including emergency services, dental care, vision care, routine checkups and doctor visits. Laboratory and X-ray services, immunizations and both inpatient and outpatient hospital services are covered as well, notes Healthcare.gov. CHIP covers pregnant women and parents in some states.

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