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Do I qualify for CHIP?

Understanding the Pennsylvania Children’s Health Insurance Program (CHIP) can be a challenge. But we’re here to walk you through the process. The first step is to see if you or your child are eligible. 


You can call Member Services at 1-800-822-2447 (TTY: 711). We’re here for you Monday through Friday, 8 AM to 5 PM.

What is CHIP?

What is CHIP?

Children's Health Insurance Program (CHIP), a one-of-a-kind program designed to provide insurance coverage to children whose families earn too much to qualify for Medical Assistance, but who could not afford to purchase private insurance. Aetna Better Health® is a managed care organization (MCO) taking part in Pennsylvania CHIP. An MCO is the health plan that provides your benefits. MCOs provide health coverage and standard benefits.


People who qualify for CHIP are covered for many benefits and services, like:    


  • Preventive care
  • Vision care
  • Dental care
  • Medications
  • Disease management
  • Behavioral health services

Benefits info

What should you know about CHIP?

What should you know about CHIP?

It’s a program for children and teens who meet certain state guidelines. Eligibility is based on your total family income and household size. Once you apply, the Pennsylvania Department of Human Services then reviews your enrollment in CHIP. If you qualify, you can choose Aetna Better Health Kids as your health plan.

More about CHIP costs    General CHIP Info

Types of CHIP coverage

If you qualify, you will be enrolled in one of three different types of CHIP coverage: free, low cost or full cost.

You will not have to pay a monthly premium or copays if you’re eligible for free CHIP.

Is your household income above the free CHIP limits? If so, and you’re eligible for low-cost or full-cost CHIP, you’ll need to pay a monthly premium and copays.

You’ll be required to pay the first month's premium to enroll in low-cost or full-cost CHIP. Thereafter, you’ll receive a monthly billing statement from Aetna Better Health Kids.

Who does CHIP cover?

Who does CHIP cover?

We serve select counties in Pennsylvania. Members fit into one or more of these groups:

  • Pennsylvania resident
  • Under age 19
  • Legal citizen or qualified immigrant
  • Not enrolled in any private, governmental group or individual health insurance program (including Medical Assistance or Medicare)

See if you qualify  

Counties we serve

Counties we serve

Adams, Allegheny, Armstrong, Beaver, Bedford, Berks, Blair, Bucks, Butler, Cambria, Centre, Chester, Clearfield, Crawford, Cumberland, Dauphin, Delaware, Erie, Fayette, Franklin, Fulton, Indiana, Lackawanna, Lancaster, Lawrence, Lebanon, Lehigh, Luzerne, Lycoming, Mercer, Monroe, Montgomery, Northampton, Northumberland, Perry, Philadelphia, Schuylkill, Somerset, Washington, Westmoreland, York

Extra support for children with special needs

Extra support for children with special needs

If your child is under 18 and meets the state’s guidelines for having a disability, they may qualify for PH-95 benefits. This is also known as Medicaid for children with disabilities. Unlike Medicaid, family size and income don’t affect PH-95 eligibility. So even if you make too much money, your child can still get coverage if they meet other requirements. 


Questions about PH-95? Just call our Special Needs Unit at 1-855-346-9828 (TTY: 711). You can call Monday through Friday, 8 AM to 5 PM.   

More about PH-95 (PDF)

Childhood listings of disabilities


What’s next?


If you think you qualify for Pennsylvania CHIP, you can check out our “how to apply” page. We'll help you get started.  


How to apply

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