CHIP in Ohio

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The Children’s Health Insurance Program (CHIP) in Ohio, also known as the Healthy Start or Healthy Families program, is a state and federally funded health insurance program established to offer uninsured children under the age of 19 quality health care. CHIP in Ohio offers its beneficiaries free and low-cost health services, including dental care, vision care and immunizations. As an alternative coverage to Medicaid for children, the CHIP program is for children and families whose income is too high to qualify for Medicaid and too low to afford private health insurance.

What is CHIP Medicaid in Ohio?

“Is CHIP considered Medicaid?” is a common question asked about the program, as many residents are not sure how closely the programs relate. While the answer to this question varies by state, CHIP in OH is an expansion of Ohio’s Medicaid program and thus not part of the basic medical assistance program. As a condition of this extension, CHIP benefits are specifically designed to aid children and pregnant mothers, whereas Medicaid benefits are not. Consequently, the two programs offer slightly different benefits.

Who is eligible to receive CHIP in Ohio?

Children’s Health Insurance Program (CHIP) eligibility is determined based on various factors. CHIP recipients in Ohio must be younger than 19 years of age and uninsured by other health care policies, with a few exceptions. Anyone seeking eligibility for CHIP in Ohio must also be an American citizen and an OH resident. Additionally, primary caregivers for dependents younger than 19 years of age can also meet CHIP eligibility requirements in order to receive health care coverage through Ohio’s program. This additional coverage for primary caregivers extends to pregnant mothers.

In order to satisfy the Children’s Health Insurance Program qualifications, applicants must meet basic household income requirements as well. Medicaid eligibility children are required to meet a very low household income requirement, but families not qualified for Medicaid may receive eligibility for CHIP assistance even if they earn slightly more income. You can download our complimentary Medicaid guide to obtain more detailed information about CHIP eligibility requirements.

Note: If a family and/or child is already receiving Medicaid coverage, the family and/or child will not be considered eligible for CHIP.

What is covered by CHIP Medicaid in Ohio?

Before understanding what is covered by CHIP Medicaid, it is important to know what plans of coverage are available to members of Ohio’s Healthy Start program. For those interested in CHIP and Medicaid enrollment, there is traditional Medicaid coverage, which offers its members the full network of primary care physicians, specialists, hospitals and health care clinics that are partnered with the Medicaid program. Additionally, the Ohio CHIP program offers a wide variety of benefits to those who do not qualify for Medicaid assistance.

CHIP enrollment, specifically, provides children and families with coverage in various areas, including:

  • Routine check-ups.
  • Mandatory vaccines.
  • Visits to the doctor.
  • Prescription medications.
  • Dental and vision care.
  • Inpatient and outpatient hospital care.
  • Laboratory and X-ray services.
  • All emergency services.
  • Pregnancy-related services for expectant mothers.

While most CHIP health care services are free, it is important for applicants to note that not all services, including dental care, are free. In any case, the cost is highly reduced.

Additionally, Children’s Health Insurance Program beneficiaries receive automatic enrollment into Ohio’s Healthchek Service. The Healthchek Service is a preventive measure that provides CHIP participants younger than 21 years of age with regular pre-screenings for various diseases, including mental health screenings. The purpose of the Healthchek program is to catch major health conditions early and to prevent diseases and other conditions from worsening.

How to Apply for CHIP in Ohio

Applicants can apply for CHIP online, by phone, in person or by mail after preparing all of the necessary documentation and information. The online application for CHIP takes roughly 20 minutes to complete and can be accessed easily as long as you have an internet connection. However, if an individual wishes to submit an Ohio CHIP application in person, he or she will need to visit a local county Job and Family Services office in order to fill out a copy of the application. Meanwhile, regarding how to apply for CHIP by mail or via fax, petitioners can also send a completed form via general delivery or fax to the local Job and Family Services office.

In order to apply for CHIP, all applicants need to have the following items prepared:

  • Proof of income
  • Employment information
  • Details regarding assets and resources
  • The birthdates of qualifying members in your home
  • Proof of pregnancy, if applicable
  • Proof of citizenship
  • Proof of other health insurance policies, if applicable
To obtain a comprehensive list of information and documents needed to apply for CHIP, download our complimentary guide.

County case workers may contact applicants via mail for additional information regarding their applications. Additionally, some candidates will be asked for a follow-up CHIP interview to provide more information. Once the county office has received all of the details required of an applicant, the process of determining final eligibility will begin.

If an applicant is determined eligible to receive CHIP assistance benefits, he or she will automatically be enrolled in a managed care plan. In addition, the Ohio CHIP recipient will receive a health insurance card in the mail with a letter explaining the extent of benefits coverage.