Children's health insurance program (CHIP)

The State Children's Health Insurance Program (CHIP) permits states to expand children's health coverage to children whose family incomes exceed the requirements for Medicaid but are insufficient to afford private insurance coverage.

CHIP is administered through the Hoosier Healthwise managed care program. The program provides preventive, primary, and acute healthcare coverage to children living in Indiana who meet the following eligibility criteria:

  • Must not have creditable health coverage or have had creditable health coverage at any time during a waiting period lasting no longer than 90 days
  • Does not live with the custodial parent who is an employee of the state of Indiana; and
  • Is a United States citizen or is a legal immigrant who has lived in the United States for a period of five years or more
  • Meets applicable income guidelines, according to the following table

Two benefit packages exist under Hoosier Healthwise for CHIP members: Package A and Package C. Package A is premium-free and does not require copayments for any services. Package C requires payment of monthly premiums as a condition of coverage. Package C also requires nominal copayments for emergency transportation and prescription drugs. The following table outlines the income guidelines for CHIP eligibility by age group:

Guidelines for CHIP Eligibility by age Group

Age

Chip Package A

CHIP Package C

Birth to
Age 1
158 - 208% Federal Poverty Level (FPL) 208 - 250% FPL
1 - 5 141 - 158% FPL 158 - 250% FPL
6 - 18 106 - 158% FPL 158 - 250% FPL

More information

For information on CHIP premiums, see the Premium Payments page: https://www.in.gov/medicaid/members/176.htm.

Refer to the Hoosier Healthwise page and the Member Eligibility and Benefit Coverage provider reference module on this site for additional information.