Children who may qualify for CHIP must meet income guidelines and be:
- Under age 19
- Not currently covered by health insurance
- US citizens or legal residents
Family Size | Maximum Gross Income Per Month | Maximum Gross Income Per Year |
---|---|---|
2 (single parent & one child) | $3,407 | $40,884 |
3 | $4,304 | $51,648 |
4 | $5,200 | $62,400 |
5 | $6,097 | $73,164 |
6 | $6,994 | $83,928 |
7 | $7,890 | $94,680 |
8 | $8,787 | $105,444 |
*Effective March 2024
Apply for CHIP online or print and mail an application.
The Department of Workforce Services (DWS) is under contract to complete all applications and process eligibility. After 2 -3 business days, you may call DWS at 1-866-435-7414 to complete your interview and/or to find out what verifications are needed to determine your eligibility. You may also go to MyCase for more information and to view the status of your case. It may take 4 – 6 weeks to process your application. If there are parts of the application that are incomplete, the process will take longer.
- Well-child exams
- Immunizations
- Doctor visits
- Hospital and emergency care
- Prescriptions
- Hearing and eye exams
- Mental health services
- Dental care
For a complete listing of services and co-pays, call your health plan, or print the CHIP co-pay summary.
Your health plan will send you a packet with covered expenses, information about pre-authorization, and a list of providers you may use. This packet will arrive with your insurance card. Call your health plan if you don’t get it within 4-6 weeks of enrolling.
CHIP is funded by the state and federal governments. CHIP families also contribute through co-pays.
CHIP is administered by the Utah Department of Health and Human Services. CHIP currently contracts with Select Health, Molina Healthcare of Utah, and Healthy U to provide healthcare services. Additionally, CHIP contracts with Premier Access to provide dental care services.
CHIP co-pay summary opens in a new tab
The following describes who does not pay co-pays:
- American Indian and Alaska Native children do not pay co-pays. A CHIP enrollee must provide tribal membership verification. The tribe must be recognized by the federal government. Acceptable verification of American Indian and Alaska Native status include:
- Tribal Identification/Enrollment Card or Number
- Certificate of Degree of Indian or Alaska Native Blood (CDIB) signed by the Bureau of Indian Affairs (BIA)
- Indian Health Services (IHS) Face Sheet (IHS Face Sheet is a medical record certified by IHS as being from their original records)
- CHIP families that do not have income in the benefit year do not have to pay co-pays or deductibles for CHIP covered services.
CHIP has three (3) health plans. You get to pick which one you want. Your HPR will give you a chart to help you pick. Your health plan will:
- Process your medical claims
- Send you medical cards
- Send you a booklet of healthcare providers for you to choose from
- Pre-authorize procedures when needed
Here are the health plan phone numbers:
Molina
1-888-483-0760
SelectHealth
1-800-538-5038
Healthy U
1-833-404-4300
Your dental and health plan should send you a card within 4-6 weeks of enrolling. If you don’t get your card, call the dental and health plan that you chose. If you lose your card, please call your dental or health plan.
If you add a new member to your family, call the DWS Eligibility Services Center to update your case (1-866-435-7414). Once you have updated your case, a new card will be mailed to you for that new family member.
If your income or household size changes, you may qualify for a lower-cost CHIP plan. You may also qualify for a different medical assistance program. To find out, you may ask for an early review. If you still qualify for CHIP, the following changes occur:
- A new 12-month benefit year begins
- You will have a new 5% maximum amount for co-pays and deductibles
- The 5% maximum amount starts over
- Co-pays or deductibles paid in the previous benefit year do not count toward the new benefit year’s maximum out-of-pocket amount
You are required to call your eligibility worker to:
- Report changes in your household, like family size, income changes, etc.
- Let them know if you move to a new address or out of state.
- Let them know, within 10 days, if you enroll in other health insurance.
If your child is still in their 12 month benefit period, they will not lose their CHIP coverage if they are enrolled in another insurance plan.
During your eligibility review, if it is determined that your child still has another insurance, they will no longer be eligible for CHIP. DWS will check for eligibility on other medical programs before closing your case. You will be notified after a decision is made.
Your local office is a Department of Workforce Services Employment Center. You may contact your eligibility office by calling toll-free 1-866-435-7414.
As of July 1, 2021, CHIP covers ABA services and ASD related physical, occupational, and speech therapy for all members who are eligible for CHIP plans B and C. Families can contact their CHIP health plan for a list of network providers who can provide ABA services.