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Learn About CHIP in Texas

Getting access to information about the Texas Children’s Health Insurance Program (CHIP) is a major priority for many parents who need medical benefits for their children. CHIP is designed to help children who do not meet Medicaid eligibility standards but still need help affording health insurance. Even if a family does not have Medicaid eligibility children in that family may still apply for help from CHIP. The program is specifically for children younger than 19 years of age and pregnant women who meet enrollment requirements. While CHIP and Medicaid enrollment are very similar, the two programs different and are managed separately by each state, including Texas. Applicants find themselves asking “What is CHIP Medicaid?” or other questions like “What is covered by CHIP Medicaid?” as they begin to research the program to see if they can get health insurance for their children. Get answers to these questions and learn how to apply for CHIP in TX by reading the helpful information in the sections below.

Texas Children’s Health Insurance Program (CHIP) Information

Like Texas, every state in the nation has a CHIP and Medicaid program, but states often structure these programs in their own ways. For example, some programs allow petitioners to apply for enrollment in CHIP and Medicaid at the same time, while others require two separate application procedures.

The CHIP program in TX, like those in other states, acts as a way to help Medicaid ineligible children who come from low income families that make too much for Medicaid. These children still need a way to afford health insurance coverage. CHIP provides health coverage to these children. Please note, CHIP is not a private insurance company but is instead a form of government benefits program. After a child applies for CHIP and has been enrolled, he or she will have access to the medical providers in network with CHIP. He or she will not have to change doctors as long as the doctor is in network. Those enrolled in Medicaid for children will generally have the same health network but different services may be covered.

Is CHIP considered Medicaid in Texas?

Many parents interested in CHIP benefits ask, “Is CHIP considered Medicaid in Texas?” when looking up the details for this program. No, CHIP and Medicaid are not the same, but CHIP is considered an extension of the Medicaid program. Children’s Medicaid is for children who come from families with low incomes or for children with disabilities. CHIP is for children whose families make too much to meet Medicaid eligibility income guidelines, but who still need health care coverage. Please be aware that there are Medicaid programs for adults and senior citizens in Texas as well.

Two of the largest differences between TX CHIP and Medicaid for children is what services are covered and the pricing of those services. While many of those who enroll in CHIP and Children’s Medicaid will have many of the same medical treatments and procedures covered, those on Medicaid may have access to more services. Medicaid eligible children will not have to pay for any of the costs of their medical care. Those on CHIP will have to pay a small yearly fee and small copayments for medical services rendered.

Who qualifies for CHIP in Texas?

Many children can be covered by CHIP in the state of Texas. Before applying for CHIP benefits, review the following list of eligible criteria for the program:

  • Applicants must be younger than 19 years of age.
  • Applicants must be a U.S. citizen or legal immigrant.
  • Applicants must be living in the state of Texas.
  • Applicants must meet income guidelines.
  • Applicants must not be insured when applying for CHIP.

The TX Children’s Health Insurance Program requires that all applicants show proof of identity, residence, immigration status and income when applying. Texas allows pregnant women who meet the income requirements to enroll in CHIP as well. Since CHIP and Medicaid are different programs, the Medicaid program for both children and adults will have different enrollment requirements.

What services are covered by CHIP in Texas?

Almost all medical care is covered by CHIP in order to ensure the good health of those in the program. The following list contains just a few examples of Texas CHIP covered services:

  • Doctor’s appointments
  • Dental care
  • Vision and hearing tests
  • Laboratory tests and x-rays
  • Prescription medication

Children on Medicaid will have the same services covered. However, if a child on Medicaid has a disability or a long-term illness, he or she may have additional Medicaid coverage that pertains to his or her condition. Please note, if medical services are rendered by an out-of-network provider, enrollees may not receive CHIP coverage for those services.

How to Apply for CHIP in Texas

Applying for CHIP in Texas is easy, as the state offers several ways to submit an application. One can apply for CHIP online by creating an account and following the prompts for submitting an application to the program. Applicants can also visit a local county office that works with the Texas Health and Human Services Commission. Applicants can also apply for CHIP benefits by mailing their application to this office. Finally, applicants can apply for CHIP in TX via the phone, and they may also call if they need help with their application. For more detailed information on how to submit a CHIP application, download our free guide today.