Alyssa Lane
The Children's Health Insurance Program (CHIP) is a federal program that provides health coverage to children in families with low to moderate incomes. Each state has the option to decide how to provide CHIP coverage, and New Jersey operates a combination CHIP program called NJ FamilyCare. CHIP is funded through the HEALTHY KIDS and ACCESS Acts, which also extended the maintenance of effort (MOE) provision, requiring states to maintain eligibility standards from 2010 through FFY 2027. New Jersey provides coverage up to 200% of the federal poverty level (FPL) through the CHIP for pregnant women option.
| Characteristics | Values |
|---|---|
| Program type | New Jersey operates a combination CHIP program called NJ FamilyCare |
| Number of children covered | 157,516 children were covered by NJ FamilyCare in FFY 2018 |
| Federal match rate | 76.50% for FFY 2020 |
| Participation rate | 93.5% of eligible children in New Jersey participated in either Medicaid or NJ FamilyCare in 2017 |
| Coverage | Health coverage for routine check-ups, immunizations, dental care, doctor visits, prescription medications, and hospital care |
| Eligibility | Children in families with low to moderate incomes; income eligibility limits vary by state |
| Enrollment | Open year-round; coverage can start immediately upon qualification |
| Cost | No cost for eligible children; families with incomes above the limit can pay the full cost to purchase coverage |
| Waiting period | Up to 90 days; the length of time a child must be uninsured before enrollment |
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What You'll Learn
- CHIP provides health coverage for routine check-ups, immunizations, and dental care
- It also covers doctor visits, prescription medications, and hospital care
- CHIP is available for children in families with low to moderate incomes
- Each state has different rules for who qualifies for CHIP
- New Jersey operates a combination CHIP program called NJ FamilyCare
CHIP provides health coverage for routine check-ups, immunizations, and dental care
The Children's Health Insurance Program (CHIP) has provided health coverage for children from low- to moderate-income families for over two decades. CHIP is available in every state, and each state has the option to cover CHIP within its Medicaid program, design a separate CHIP program, or establish a combination of the two. New Jersey operates a combination CHIP program called NJ FamilyCare. In FFY 2018, 157,516 children were covered by NJ FamilyCare.
Each state has its own rules about who qualifies for CHIP, and there may be waiting periods of up to 90 days before enrollment. Families with incomes above the upper income eligibility limit may be allowed to pay the full cost of purchasing coverage for their uninsured children through CHIP. CHIP is funded through the HEALTHY KIDS and ACCESS Acts, which have extended the maintenance of effort (MOE) provision. This requires states to maintain eligibility standards from 2010 through FFY 2027. However, beginning in FFY 2020, the MOE only applies to children in families with incomes at or below 300% of the federal poverty level (FPL).
In addition to coverage for children, states can opt to provide coverage for pregnant women and/or services through the "unborn child" coverage option. New Jersey provides coverage up to 200% FPL through the CHIP for pregnant women option.
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It also covers doctor visits, prescription medications, and hospital care
The Children's Health Insurance Program (CHIP) is a federal program that has provided health coverage for children in families with low to moderate incomes for over two decades. Each state has the option to cover its CHIP population within its Medicaid program, design a separate CHIP program, or establish a combination of the two. New Jersey operates a combination CHIP program called NJ FamilyCare.
CHIP covers doctor visits, prescription medications, and hospital care. Routine "well child" doctor and dental visits are free under CHIP, but there may be a copayment for other services. For example, some states charge a monthly premium for coverage, regardless of whether services are used.
New Jersey's CHIP program, NJ FamilyCare, covered 157,516 children in FFY 2018. The federal government matched 76.50% of the state's costs that year. In 2017, 93.5% of eligible children in New Jersey participated in either Medicaid or NJ FamilyCare.
In addition to covering doctor visits, prescription medications, and hospital care, CHIP also provides Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) services. This benefit ensures that enrolled children receive comprehensive health coverage.
Overall, CHIP is a vital program that ensures children in low- to moderate-income families have access to the healthcare they need, including doctor visits, prescription medications, and hospital care.
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CHIP is available for children in families with low to moderate incomes
The Children's Health Insurance Program (CHIP) has provided health coverage for children in low- to moderate-income families for over two decades. CHIP is currently funded through the federal fiscal year (FFY) 2027 by the HEALTHY KIDS and ACCESS Acts. Each state has its own CHIP program, and families can apply for coverage at any time.
States have the option to cover CHIP within their Medicaid programs, design a separate CHIP program, or establish a combination of both. New Jersey has chosen to operate a combination CHIP program, which means it provides coverage for children in families with incomes up to 200% of the federal poverty level (FPL). States with Medicaid expansion CHIP programs must follow Medicaid rules and provide all Medicaid-covered benefits to enrolled children, including Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) services.
Families with incomes above the upper income eligibility limit may still be able to purchase coverage for their uninsured children through CHIP by paying the full cost. Additionally, states can implement waiting periods of up to 90 days for CHIP enrollment, which is the length of time a child must be uninsured before they can be enrolled in the program.
If a family applies for Medicaid coverage, they will also find out if their children qualify for CHIP. CHIP coverage is typically more affordable than individual insurance plans, and families may be able to save on Marketplace coverage.
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Each state has different rules for who qualifies for CHIP
The Children's Health Insurance Program (CHIP) is a joint federal and state program that provides health coverage to children in families with low to moderate incomes. Each state has different rules for who qualifies for CHIP, and states have the flexibility to adopt their own eligibility standards within federal guidelines. For example, some states have programs for specific geographic areas or for children with disabilities.
In New Jersey, the state operates a combination CHIP program called NJ FamilyCare. In FFY 2018, 157,516 children were covered by NJ FamilyCare. New Jersey provides coverage up to 200% of the federal poverty level (FPL) through the CHIP for pregnant women option.
In Pennsylvania, CHIP eligibility is determined by tax deductions that reduce the household's adjusted gross income based on IRS tax rules. Additionally, Pennsylvania CHIP can extend eligibility to families who meet a hardship exception, such as when the employee works part-time and premiums and cost-sharing exceed 5% of the family's annual income.
Across all states, CHIP beneficiaries must meet certain non-financial eligibility criteria. They must be residents of the state in which they are receiving CHIP and must be either citizens of the United States or certain qualified non-citizens, such as lawful permanent residents.
While each state's CHIP benefits differ, all states provide comprehensive coverage, including routine "well-child" doctor and dental visits. Some states may offer additional benefits beyond these standard offerings.
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New Jersey operates a combination CHIP program called NJ FamilyCare
In the United States, the Children's Health Insurance Program (CHIP) provides health coverage for children from families with low to moderate incomes. Each state has the option to cover CHIP within its Medicaid program, design a separate CHIP program, or establish a combination of the two. New Jersey operates a combination CHIP program called NJ FamilyCare.
The NJ FamilyCare program covers children so that they can get routine check-ups, immunizations, and dental care. It also covers doctor visits, prescription medications, and hospital care when they are sick, among other benefits. In FFY 2018, 157,516 children were covered by NJ FamilyCare. The same year, 93.5% of eligible children in New Jersey participated in either Medicaid or NJ FamilyCare.
CHIP is funded by the federal government, with each state having its own program and rules about who qualifies. In FFY 2020, the federal match for New Jersey was 76.50%. The Affordable Care Act increased the federal CHIP match rate by 23 percentage points, and this increase was maintained through FFY 2019. In FFY 2020, the increase was reduced to 11.5 percentage points, and in FFY 2021 and beyond, the federal CHIP match rate returned to the state's regular enhanced match rate.
States that operate Medicaid expansion CHIP programs must follow Medicaid rules, providing all Medicaid-covered benefits to enrolled children, including Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) services. In separate CHIP programs, states have substantial flexibility in designing CHIP benefit packages within broad federal guidelines. Within federal parameters, states can set CHIP program premium and cost-sharing levels. Importantly, any family contribution to the cost of coverage cannot exceed 5% of family income annually.
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Frequently asked questions
CHIP is an insurance program that provides health coverage to children in families with low to moderate incomes.
New Jersey operates a combination CHIP program called NJ FamilyCare. This program covers children in families with incomes up to 200% of the federal poverty level (FPL).
Each state has its own rules about who qualifies for CHIP. To find out if your child is eligible, you can apply to your state agency for Medicaid coverage, and they will also determine if your child qualifies for CHIP.
