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Learn About CHIP in Illinois

Since the late 1990s, the Children’s Health Insurance Program (CHIP) has been available in all states in including Illinois. CHIP provides health insurance coverage to children that their parents or guardians may not be able to afford. Both CHIP and Medicaid enrollment are funded by the same sources and have similar application procedures, yet there are different guidelines that govern the two programs. To find out what is CHIP Medicaid and what is covered by CHIP Medicaid in Illinois, continue reading the outlined information below.

What is Illinois’s Children’s Health Insurance Program?

CHIP and Medicaid for children are government health care programs dedicated to providing coverage to resident who are eligible for Medicaid benefits. However, the Children’s Health Insurance Program exists to provide coverage to children whose families may have too much income to qualify for Medicaid but still need help affording health care. Even if the parents in family do not have Medicaid eligibility children can still apply for CHIP. Once children are enrolled in CHIP, they are free to see any medical provider who is in-network with IL CHIP.

For more details on requirements, download our free guide and review the comprehensive information.

Is CHIP considered Medicaid in Illinois?

While Medicaid and CHIP are both funded by a mixture of state and federal sources, CHIP is not considered Medicaid but is an extension of the program. Illinois Medicaid for children does not require recipients to cover any costs of their medical services. However, those enrolled in Children’s Health Insurance Program in IL will have to pay a small premium and portion of their medical services. The amount a recipient’s family will need to pay will depend on their earnings compared to the income requirements of the Medicaid program.

While children are eligible for Medicaid and CHIP automatically due to age, the income and extended family member requirements are the main differences between these two programs. For instance, for a child’s family to be eligible for Medicaid in IL, the household must meet the low-income requirements as well as meet prerequisites pertaining to age and health status. Certain life events, such as the loss of a parent’s job, may influence a child who was enrolled in CHIP to become Medicaid eligible. Parents who apply to Medicaid and find out they are ineligible, may still be able to register their children in CHIP.

Who qualifies for CHIP in Illinois?

The criteria for applying to the Children’s Health Insurance Program is different from Medicaid’s criteria. Illinois CHIP allows individuals who meet the following specifications to enroll in the program:

  • Applicants must be younger than 19 years of age
  • Applicants must come from families that meet the income guidelines
  • Applicants must not have private insurance
  • Applicants must be a United States citizen or a legal alien

During the CHIP enrollment process, you will have to provide proof of identity, income and citizen or immigration status. Please be aware that giving false information while applying for government benefits is considered benefits fraud and is a criminal offense that often comes with jail time. Many states allow pregnant women to enroll in CHIP, but pregnant mothers in Illinois with Medicaid eligibility can apply to that program instead.

What services are covered by CHIP in Illinois?

A large variety of health services are covered by CHIP in the state of Illinois. The program aims to help Medicaid ineligible children remain in good health by having access to affordable medical services and preventative care. These services and many more are covered by the CHIP program:

  • Hospital stays and emergency care
  • Doctor’s appointments
  • Routine check-ups and shots
  • Vision, dental and hearing care
  • Physical therapy and laboratory tests

After applying for CHIP, applicants and their families will learn more about which treatments can and cannot be covered by the program. In general, services that have not been scientifically proven to be effective such as acupuncture or acupressure will not be covered. CHIP eligible children will need to see providers who are in-network with CHIP or the services may not be fully covered by the program.

How to Apply for CHIP in Illinois

Applying to CHIP is a simple process. Both CHIP and Medicaid enrollment can be completed online by logging into your GetCoveredIllinois account. The website will offer prompts on how to check your eligibility and how to proceed with your application. You can also apply for CHIP benefits by calling the Illinois CHIP information number at 866-255-5437. Those who have questions about the CHIP application can email the following address:

Those who apply to Medicaid coverage and are denied can still apply for Children’s Health Insurance Program. However, enrollment does not last a lifetime and beneficiaries will need to reapply for CHIP every 12 months. All important documents about CHIP benefits and reapplying to the program will be sent through the mail. After applying for CHIP, most applicants will find out about their enrollment status in about 30 to 45 days after submitting their application.

Download our free guide for more details on applying to the Medicaid program.