1. What is CHIP?
CHIP is Utah's Children’s Health Insurance Program, it is a federally funded state health insurance program for children of working families. (Click here for CHIP overview)
TOP

2. Who is eligible for CHIP?
Children who may possibly qualify for CHIP are:
• Under age 19
• Not currently covered by health insurance
• US citizens or legal residents; and
• Meet income guidelines

*2004 Income Guidelines

TOP

3. When can I apply?
CHIP is not taking applications right now. Please check back often, we will post the dates for the next Open Enrollment when it is announced.

The dates and length of Open Enrollment periods are determined by how many children enroll, the number who leave the program, and available funding.
TOP

4. How do I apply for CHIP?
During Open Enrollment, apply for CHIP online, by mailing an application, or by visiting a Utah Department of Health eligibility office.
TOP

5. Why does Utah need CHIP?
Children without health insurance often don't get regular health care. They may wait until an emergency occurs when they are sicker and treatment costs more. CHIP covers families who would otherwise go uninsured; insuring a healthier future.
TOP

6. How is CHIP paid for?
CHIP is funded by the state and federal governments. CHIP receives four federal dollars for each state dollar. All state funding is from the Tobacco Master Settlement Agreement. CHIP families also contribute through co-pays and premiums.
TOP

7. What health care services will CHIP pay for?
Because preventive care is so important, CHIP doesn't require a co-pay for well-child check ups and immunizations. CHIP offers great medical and dental benefits. Call your health plan for details,or view the CHIP co-pay summary.
TOP

8. Who operates CHIP?
CHIP is administered by the Utah Department of Health. CHIP currently contracts with PEHP and Molina Healthcare of Utah to provide health care services.
TOP

9. What are the co-payments for CHIP?
Click here to view/print the CHIP co-pay schedule.
TOP

10. What if my child has a pre-existing condition?
CHIP does not consider pre-existing conditions when determining eligibility for your child. There are no pre-existing condition waiting periods for CHIP.
TOP

11. How do I choose a health plan?
CHIP has 2 health plans. You get to pick which one you want. Your eligibility worker will give you a chart to help you pick.
Your health plan will:

• Process your medical claims
• Send you medical cards
• Send you a booklet of health care providers for you to choose from
• Pre-authorize procedures when needed

Here are the health plan phone numbers:

• Molina
801-858-0400 or toll-free 1-888-483-0760

• Public Employees Health Program (PEHP)
801-366-7555 or toll-free 1-800-765-7347

Dental
• Public Employees Dental Program (PEDP)
801-366-7555 or toll-free 1-800-765-7347
TOP

12. When will I get my medical card?
Your health plan should send you a card within 4-6 weeks of enrolling. If you don’t get your card, call the health plan that you chose. If you loose your card, please call your health plan. Molina will send you a card for each family member on CHIP. PEHP will send just one card for your family.
TOP

13. What should I do if my children need health care before we get the medical card?
Call your CHIP health plan and they will help you. (In some cases you will need to pay for services and then be reimbursed).
TOP

14. Will I get a new card if I add a family member to CHIP?
If you are covered through Molina, and you add a family member to CHIP, you will get a card for that child.

PEHP issues one medical card per family. If you are covered by PEHP and you add a family member, you will not get a new card.
TOP

15. How do I know what is covered by CHIP?
Your health plan will send you a packet with covered expenses, information about pre-authorization, and a list of providers you may use. This packet will arrive with your insurance card. Call your health plan if you don’t get it within 4-6 weeks of enrolling.
TOP

16. What are premiums?
Most CHIP families are required to pay a premium every quarter. By paying your premiums, you are helping CHIP cover more children.

You will receive a quarterly premium statement, due in February, May, August, and November of each year. Depending on your income you will either pay nothing, $13 a quarter, or $25 per quarter, no matter how many kids are in your family. Some families aren’t asked to pay a premium, like Native Americans and those who are exempt because of their income. You won’t be asked to start paying premiums until the second quarter you are on CHIP.

If you would like to pay your premiums by credit card or if you have premium questions, call the toll-free CHIP premium line at 1-866-772-1261.
TOP

17. What is the maximum I need to pay?
Most people on CHIP are required to pay premiums and co-pays. But, CHIP will not ask you to pay more than 5% of your family’s income (minus your CHIP quarterly premiums) in co-pays and premiums per year (July1st – June 30th). Save your co-pay receipts so you can show how much you paid. If you think you may be getting close to this amount, call us toll-free at 1-866-772-1261.
TOP

18. Am I required to report changes in my eligibility?
You are required to call your eligibility worker to:
• Report changes in your household, like family size, income changes, etc.
• Let them know if you move to a new address or out of state.
• Let them know, within 10 days, if you enroll in other health insurance.
TOP