1. What is CHIP?
The Children's Health Insurance Program, or CHIP is a state health insurance plan for children. Depending on income and family size, working Utah families who do not have other health insurance may qualify for CHIP.
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2. Who is eligible for CHIP?
Children who may qualify for CHIP must meet income quidelines and be:
• Under age 19
• Not currently covered by health insurance
• US citizens or legal residents

*2008 Income Guidelines

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3. When can I apply?
Apply anytime. CHIP is now accepting applications year-round.
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4. How do I apply for CHIP?
Apply for CHIP online or print and mail an application.
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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 is a good call for kids.
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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.
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7. What does CHIP cover?
• Well-child exams
• Immunizations
• Doctor visits
• Hospital and emergency care
• Prescriptions
• Hearing and eye exams
• Mental health services
• Dental care
For a complete listing of services and co-pays, call your health plan, or print the CHIP co-pay summary.
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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.
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9. What are the co-payments for CHIP?
Click here to view/print the CHIP co-pay schedule.
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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.
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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
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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.
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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).
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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.
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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.
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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, $30 a quarter, or $60 per quarter, no matter how many kids are in your family. Some families aren’t asked to pay a premium, like American Indians 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. (Our business hours are Monday through Thursday, from 7:00 a.m. to 6:00 p.m.)
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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.
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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.
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19.Where is my local office?
Your local Department of Workforce Services Employment Center. To find the office nearest you click here.
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