Texas CHIP Plan
What is CHIP?
CHIP is a health insurance plan for children under the age of 19. It is for families who:
Earn too much money to qualify for Texas Medicaid programs and cannot afford to buy private insurance
How does CHIP work?
Members choose an HMO and a Primary Care Provider to give them all of their primary care services. This includes coordinating referrals for all medically-necessary specialty services.
Families who make between 100% and 200% of the Federal Poverty Level (FPL) may be eligible to participate in CHIP. Annual enrollment fees are $50 or less per family. Most co-payments for doctor visits and prescription drugs are $16 or less.
What services does CHIP cover?
CHIP Members get medical care that includes:
- Hospital care
- Surgery
- X-rays
- Physical/speech/occupational therapies
- Prescription drugs
- Emergency services
- Transplants
- Regular health checkups and immunizations
CHIP Perinatal Plan
Are you pregnant? Do you need coverage for your unborn baby? Learn more about the CHIP Perinatal plan.
Texas Children's Health Insurance Program and CHIP-Perinatal FAQs
The Children's Health Insurance Program (CHIP) is a jointly funded state-federal program. The U.S. Congress has not funded CHIP. HHSC is monitoring the status of CHIP federal funding. The Centers for Medicare and Medicaid Services (CMS) has provided preliminary information to suggest that Texas will have funding for CHIP through February 2018. As of today if you have CHIP, you can go to the doctor and get your medicine. Click here to learn more.
Service Area Map
CHIP VALUE-ADDED SERVICES
* What Value-Added Services does a Community Health Choice CHIP Member get? How can I get these benefits/how can I get these benefits for my child?
We offer the following extra benefits to our CHIP Members. Limitations may apply. Call us at 713.295.2294 or toll-free at 1.888.760.2600 and a Member Services Representative will help you. These services are in effect from September 1, 2017 to August 31, 2018.
24-Hour Nurse Help line
You can call our Nurse Help line 24 hours a day, seven days a week toll-free at 1.888.332.2730. Call the Nurse Help line before going to the emergency room unless it is an emergency. A nurse will answer your health care questions and help the CHIP Member get the care they need.
Vision Benefits
Our Members will receive $100 off the cost of contact lenses instead of glasses, if they choose. The $100 discount only applies if contact lenses are not covered as part of the standard CHIP benefit. Members get the $100 discount at the time they are eligible for new eyewear. You may get eyewear every 12 months. CHIP Members may receive one pair of replacement eyeglasses every 12 months.
Transportation Services
We offer free transportation for CHIP Members to doctors’ appointments when no other transportation is available and when approved by our case manager. You must call us for approval at least three business days before the CHIP Member’s appointment. This value-added service is only available to CHIP Members where transportation services are available.
Sports and School Physicals
We will pay our Network Providers for sports and school physicals for CHIP Members age 4 to 19, limited to one per year.
Care Management Program
We have care management programs (including services) for asthma and diabetes. We also have a High-Risk Perinatal Program to help our pregnant Members with high-risk pregnancies.
Boys and Girls Club Membership
Children 7-17 years old can join the Boys and Girls Club for free! This is for Harris and Jefferson Service Area Members only. Limitations may apply.
Neighborhood Centers, Inc. (NCI) Membership
For CHIP Members in the Harris Service Area. We will pay 100% of the membership cost, once per year, to the Neighborhood Centers, Inc. (NCI) of their choice in the Harris Service Area. The membership only covers health and wellness classes. Limitations may apply.
Youth Sports League Fee Allowance
We will pay up to $40 annually toward the cost of a Member’s registration fee for a youth sports league.
Tobacco Cessation
Up to $150 in medically approved coverage for any non-covered tobacco cessation programs, prescriptions, and products.
* What Value-Added Services does a Community Health Choice CHIP Perinatal Newborn Member get? How can I get these benefits for my child?
We offer the following value-added benefits to our CHIP Perinatal Members. If you need help, call us at 713.295.2294 or toll-free at 1.888.760.2600 and a Member Services Representative will help you. These services are in effect from September 1, 2017 to August 31, 2018. Call Member Services if you have any questions.
24-Hour Nurse Help line
You can call our Nurse Help line 24 hours a day, seven days a week toll-free at 1.888.332.2730. Call the Nurse Help line before going to the emergency room unless it is an emergency. A nurse will answer your health care questions and help the CHIP Newborn Member get the care they need.
Care Management Program
We have care management programs (including services) for asthma and diabetes. We also have a High-Risk Perinatal Program to help our pregnant Members with high-risk pregnancies.
Transportation Services
We offer free transportation for CHIP Members to doctors’ appointments when no other transportation is available and when approved by our case manager. You must call us for approval at least three business days before the CHIP Member’s appointment. This value-added service is only available to CHIP Newborn Members where transportation services are available.
* What Value-Added Services does a Community Health Choice CHIP Perinatal Unborn Member get? How can I get these benefits for my unborn child?
We offer the following value-added benefits to its CHIP Perinatal Members. If you need help, call us at 713.295.2294 or toll-free at 1.888.760.2600 and a Member Services Representative will help you. These services are in effect from September 1, 2017 to August 31, 2018. Call Member Services if you have any questions.
24-Hour Nurse Help line
You can call our Nurse Help line 24 hours a day, seven days a week toll-free at 1.888.332.2730. Call the Nurse Help line before going to the emergency room unless it is an emergency. A nurse will answer your health care questions and help you get the care your unborn child needs.
Care Management Program
We have a Perinatal Program to help our pregnant Members with high-risk pregnancies. Our nurses will help you learn how to take care of your pregnancy. We focus on asthma, diabetes, heart failure, and high-risk pregnancy.
Neighborhood Centers, Inc. (NCI) Membership
For CHIP Perinate Members in the Harris Service Area. We will pay 100% of the membership cost, once per year, to the Neighborhood Centers, Inc. (NCI) of their choice in the Harris County Service Area. The membership only covers health and wellness classes. Limitations may apply.
Childbirth Classes
Classes are offered at multiple sites and at our office. There is no cost. This is available only in the Harris Service Area. Transportation assistance available in the Harris Service Area.
Transportation Services
We offer free transportation for CHIP Members to doctors’ appointments when no other transportation is available and when approved by our case manager. You must call us for approval at least three business days before the CHIP Member’s appointment. This value-added service is only available to CHIP Unborn Members where transportation services are available.