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.
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.
Service Area Map
VALUE-ADDED SERVICES
Value-Added Services are effective September 1, 2019 to August 31, 2020. Limitations may apply. If you have any questions, call Member Services toll-free at 1.888.760.2600.
- 24-Hour Advice Hotline
- Nurse Help Line for all Members 24 hours per day to help Members decide where to go to get the care needed. The nurses also provide health education, nurse-initiated follow-up, and network referrals.
- Extra Vision Services
- Members receive a $100 allowance each year towards the choice of: (1) upgrades for frames, lenses, and lens options or (2) contact lenses. The benefit period is measured from the date of service. When contact lenses are chosen, the allowance is applied to the participating provider’s retail cost for the contact lenses and professional services specific to contact lens wear, e.g., fitting, assessment and follow-up. Members who elect to upgrade their eyewear purchase with a retail value greater than the $100 allowance are financially responsible for paying the participating provider’s usual and customary (retail) cost of the difference between the cost of the eyewear selected and the $100 allowance.
- Transportation Services
- Extra help with getting a ride to a doctor’s visit when state services are not available.
- Sports and School Physicals
- One each year for Members age 4 through 19.
- Disease Management
- Educational materials for Members who are enrolled in our Asthma and Diabetes Care Management Programs.
- Help for Members with Asthma
- Asthma educational materials and one allergy-free pillowcase each year to Members enrolled in our Asthma Care Management Program. Member gets one pillowcase per year based on when Member received one before.
- Health and Wellness Services
- Up to $100 allowance towards an annual Baker Ripley membership in the Harris Service Area.
- Healthy Play and Exercise Programs
- $30 gift card each year for school-aged Member up to grade 12 who are in a school-sponsored extracurricular sports.
- Healthy Play and Exercise Programs
- $40 gift card each year for Members up to grade 12 who participate in a youth sports league (apart from extra-curricular, school sponsored activities).