CHIP in Washington DC

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Each year, the DC Children’s Health Insurance Program (CHIP) provides affordable health care coverage to thousands of children living in low-income households. The DC CHIP program, in partnership with the federal government, helps fill the gap between Medicaid and private insurance for those children living in families that make too much money to meet Medicaid qualifications, but not enough to buy private health insurance directly from the Marketplace. Applying for CHIP and Medicaid enrollment in Washington DC is a relatively simple process, as DC is one of the few areas that offers its CHIP program through an expansion in Medicaid, rather than as a separate or combined program, giving a succinct answer to the popular question, “Is CHIP considered Medicaid in Washington DC?” The following paragraphs offer helpful information regarding the Children’s Health Insurance Program (CHIP) in DC, while briefly reviewing the program’s relationship to Medicaid. Read more about CHIP coverage in DC in the sections below.

Overview of DC CHIP

The Washington DC CHIP program, along with its Medicaid for children offering, is administered through the Department of Health Care Finance (DHCF). The CHIP and Medicaid for kids services are available to children who meet certain eligibility requirements, and whose households have incomes that fall within certain thresholds. Health plans are available through the District’s health insurance marketplace, called DC Health Link. Since the Washington DC CHIP program is run as an extension of Medicaid, petitioners can successfully learn how to apply for Medicaid and CHIP on the DC Health Link website, and file paperwork simultaneously. The Department of Health Care Finance (DHCF) will then determine the applicant’s eligibility for health care coverage based on income and non-income eligibility requirements.

In terms of what is covered by CHIP Medicaid in Washington DC, petitioners will find that coverage under both CHIP and Medicaid extends across a wide variety of services. These include routine services like check-ups, doctor visits, X-rays and laboratory tests, as well as emergency services, hospital stays and much more. The programs also offer vision, dental and mental health coverage for all enrollees. Because the Washington DC CHIP and Medicaid programs are not subject to open enrollment periods the way private insurance is, petitioners may apply for coverage at any time. Coverage under CHIP and Medicaid takes effect on the date the application has been received.

What is CHIP Medicaid in Washington DC?

The Washington DC Children’s Health Insurance Program is administered by the Department of Health Care Finance (DHCF) through the DC Healthy Families program. This program provides CHIP Medicaid coverage through managed care health plans to residents of Washington DC who meet the program’s eligibility requirements. This children’s Medicaid has the same application process as regular Medicaid. Those receiving coverage under DC Healthy Families will receive financial assistance paying for all covered services, including well-child and sick-child doctor visits, shots, eye care and many other services.

Washington DC CHIP Eligibility

To be eligible for the DC CHIP program, applicants must be children, parents or guardians of children, younger than 19 years of age and living alone or pregnant. To receive CHIP or Medicaid coverage, they must also live in Washington DC and be either U.S. citizens or qualified aliens with proof of immigration status. Additionally, to receive coverage under CHIP or Medicaid, children must be living in families making gross monthly incomes at roughly 200 percent of the Federal Poverty Level (FPL) or less. Percentages for coverage in CHIP and Medicaid, however, may vary with income limit standards. Download our free guide to review more information on FPLs and income limits.

How to Apply for CHIP in DC

The steps to apply for CHIP in Washington DC are relatively simple, as the District’s primary Medicaid agency (the Department of Health Care Finance), offers DC residents various avenues for submitting applications. Those interested in DC CHIP or Medicaid coverage for their children have the options of applying online, by phone, by mail, by fax or in person. Applicants seeking to enroll in Medicaid or CHIP will need their Social Security Numbers or immigration document numbers, birthdates and income information for everyone in the household, including W-2 forms, tax statements or paystubs. Those applying for health care coverage through CHIP or Medicaid should also include policy numbers for any existing health insurance plans, in addition to information about coverage available to any family member through a job.

Washington DC CHIP applications are available online through the DC Health Link website. The steps for applying for CHIP are the same with the DC Children’s Health Insurance Program as for Medicaid, so applicants must use the same application. Those applying by phone should contact the DC Health Link Customer Service line. To apply by mail, petitioners should download and print an application for health coverage from the DC Health Link and mail it to:

Department of Human Services
Economic Security Administration
Case Record Management Unit
P.O. Box 91560
Washington, DC 20090

Applications can also be faxed to the Economic Security Administration (ESA) at 202-671-4400. Finally, petitioners may apply in person at their nearest ESA Service Centers.

Learn more about CHIP coverage by downloading our complimentary guide.