In addition to Medicaid, there are other government health insurance plans for low-income individuals. One such program is CHIP, or the Children’s Health Insurance Program. CHIP is childrens insurance, so it does not cover adults. However, certain qualifying pregnant women in some states may be able to get coverage through this plan.

Whereas Medicaid provides free or low cost health insurance to both individuals and families with children, CHIP insurance extends coverage to children without insurance and whose families would not otherwise meet income qualifications for coverage under Medicaid. So, it’s possible for you to not qualify for Medicaid because of your income, but your children may be able to qualify for CHIP.

4
Medicaid vs. CHIP: Coverage Options for Qualifying Children and Pregnant Women
BACK 4 of 4

For example, a child in Alabama could only be covered by Medicaid if the household income was 146% of the federal poverty line. But that same child could be covered by CHIP as long as the household income was no more than 317% of the federal poverty line.

CHIP is a state insurance program like Medicaid, though much of the funding for it comes from the federal government. As a result, each state’s CHIP healthcare program must conform with federal coverage requirements. 

State CHIP programs are typically administered through the same state agencies that administer Medicaid and have different names in each state. For example, the CHIP program in Georgia is called Peachcare insurance, while the CHIP program in Maine is known as CubCare.

Medicaid for pregnant women is available for women who meet the income threshold. However, some pregnant women who don’t qualify for Medicaid based on their income may be able to get coverage for themselves and/or their infant through CHIP. States that extend CHIP coverage to pregnant women can determine the type and length of coverage.

If you are pregnant and think you may qualify for Medicaid or CHIP, you should apply as soon as possible. If you qualify, you can get your prenatal medical visits covered. The CHIP insurance application process is the same as Medicaid – you can apply on the insurance marketplace.

When the agency reviews your application, it analyzes your family situation (like if you have children and/or are pregnant) and your income. If you do not meet Medicaid’s income requirements but do meet those for CHIP, your children (and you, if you are pregnant and your state extends coverage to you) can get automatically enrolled in CHIP. 

If you are pregnant and do not qualify for either CHIP or Medicaid, having a baby counts as a qualifying event for a special enrollment period (SEP). This means you can apply for a different health insurance plan through the marketplace as soon as your baby is born.

BACK 4 of 4

By Admin