Who is eligible for CHIP?
To be eligible, your child or teen must:
- > Be a resident of Pennsylvania
- > Be under the age of 19
- > Be a United States citizen, U.S. National or Qualified Alien
- > Not be enrolled in any private, governmental group, or individual health insurance program including Medical Assistance or Medicare.
Click here for income guidelines.
Most families receive CHIP coverage for free, Others get coverage at a low cost. Whether CHIP is free or low cost depends on the household size and income.
Due to changes in our provider network, Aetna no longer offers CHIP coverage in the following counties:
| Allegheny | Carbon | Lawrence |
| Armstrong | Clarion | Mercer |
| Beaver | Erie | Schuylkill |
| Blair | Fayette | Somerset |
| Butler | Greene | Washington |
| Cambria | Jefferson | Westmoreland |
If this change affects you or your child, please be assured that we will transfer your CHIP coverage to another CHIP health insurance company in your county, and you or your child will continue to receive their CHIP benefits. We are here to answer any questions you may have. Please call our Member Services at 1-800-822-2447, Monday through Friday from 8:00 a.m. to 4:30 p.m.
For CHIP enrollees who are affected by this change, we have provided you with a list of Frequently Asked Questions to assist you in this transition.
Free CHIP
If your child is eligible for Free CHIP, you will not have to pay a monthly premium or copays.
Low-Cost CHIP and Full-Cost CHIP
If your child is eligible for Low-Cost or Full-Cost CHIP, you will need to pay a monthly premium and co-payments. See the chart below for information on monthly payments.
Note: To be enrolled in Low-Cost or Full-Cost CHIP, you will be required to pay the first month's premium, prior to enrollment. Thereafter, you will receive a monthly billing statement from Aetna.
Costs
Low Cost 1 |
Low Cost 2 |
Low Cost 3 |
Full-Cost |
|
|
Southeastern Pennsylvania Counties: Berks, Bucks, Chester, Delaware, Lehigh, Montgomery, Monroe, Northampton, Philadelphia |
$60.55 |
$84.77 |
$96.88 |
$236.55 |
|
Central Pennsylvania Counties: Adams, Cumberland, Dauphin, Franklin, Fulton, Lancaster, Lebanon, Perry, York |
$50.09 |
$70.13 |
$80.14 |
$195.72 |
Late or Missed Payments
If your monthly payment is over 30 days late or is not paid at all, your child's coverage will end on the last day of the month that a payment was received. You will be responsible for any medical or dental costs after the date the coverage ended.
If your coverage is terminated, you will be required to reapply for benefits in order to have coverage reinstated and you may be subject to a 6 month waiting period.
Questions?
If you have questions call 1-800-822- 2447 or TTY at 1-800-628-3323. We are here Monday through Friday from 8 a.m. to 5 p.m.