FirstStep
State Children’s Health Insurance Program (SCHIP)
SCHIP Q & A
Source: Centers for Medicare & Medicaid
Services, State Children’s Health Insurance Program
General Questions about SCHIP
What is SCHIP?
The State Children's Health Insurance Program (SCHIP) provides health insurance
to uninsured, low-income children 18 years of age or younger, including those
who are homeless. Each state operates SCHIP using its own name. For example,
in New Mexico, the program is called New Mexikids, and in Georgia, it’s
called PeachCare.
Where can I access more information
about SCHIP?
For more information on SCHIP, please visit the State Children’s Health
Insurance Program at http://cms.hhs.gov/schip/.
For specific information on the SCHIP program offered in
your state, please visit either www.cms.hhs.gov/medicaid/allstatecontacts.asp or
www.insurekidsnow.gov/states.htm.
Are my client’s children eligible
for SCHIP?
Although each state has different eligibility rules, in most states your client's
children are eligible for SCHIP if they:
- Are uninsured and 18 years old or younger and have low income
- Meet the specific SCHIP eligibility criteria established by your state
Your state will determine whether your client’s child is eligible for Medicaid prior to enrollment in SCHIP. Federal law requires that ineligibility for Medicaid be established prior to approval for SCHIP coverage. Please see the Medicaid section of this tool for more information on Medicaid eligibility.
How should my clients apply for
SCHIP benefits?
Your clients can call 1-877-KIDS-NOW (1-877-543-7669) to find out how to get
an application to apply to the state SCHIP program on behalf of their children.
In some states, the application can be completed over the phone or online.
In other states, the application may need to be sent in through the mail.
Do parents have to apply for SCHIP?
What happens if the child’s caretaker is neither a legal guardian
nor confirmed parent? Who fills out the application?
NO. The parent is not required to apply for a SCHIP enrollment. In addition
to parents, in many states, grandparents and legal guardians can also enroll
children in their care for SCHIP. Each state has its own rules about who can
apply, like parents, grandparents, or guardians. Call 1-877-KIDS-NOW (1-877-543-7669)
for more details.
What is the best way to submit applications
for SCHIP? The Internet, U.S. mail or fax? Where can my client download
or find the applications they need?
It is best to contact 1-877-KIDS-NOW (1-877-543-7669) to determine the options
for submitting applications in an individual state. Some states have the application
available on their state SCHIP Web site, making it possible for your clients
to submit their applications online.
What information will my client
need to apply for SCHIP benefits?
The information needed to apply for SCHIP varies from state to state. Your
client can find out exactly what information is needed in his/her state by
calling 1-877-KIDS-NOW (1-877-543-7669).
How long is the typical turn-around
for application approval?
The application timeframe for SCHIP enrollment varies from state to state.
In general, the application review may take as little as five to 10 days, or
as long as 45 days.
Will my clients have to renew their
SCHIP eligibility?
Yes. Your clients will have to renew their SCHIP eligibility, but the time
at which they must renew is determined by your state. Toward the end of a specified
coverage period, your clients will be notified in writing that action is needed
in order to continue coverage. Your client will have to update information,
either by submitting income (if your client is receiving any type of income)
and other verification documents, or by self-declaring information required
by your state to renew eligibility.
Your state may send your client a pre-printed form that your client must update to verify that his/her eligibility information has either changed or remained the same. Some states require that the form be signed and returned. In other states, if the information sent to your client is correct, he/she need not return the form or contact eligibility staff to continue receiving benefits.
If my client’s child is an
immigrant, is he or she still eligible for SCHIP?
Your client’s child may be eligible for SCHIP if he/she is an immigrant.
Your client will need to provide immigration status information for the child
applying for SCHIP coverage and may need to provide the child’s Social
Security number.
As a general rule, only “qualified aliens” may be eligible for SCHIP coverage. In addition, some immigrants cannot be eligible for coverage for five years from the date they enter the country as a qualified alien.
Parents who are not applying for benefits cannot be required to give their Social Security numbers to get health insurance for their children. For more information about the current rules for immigrant SCHIP eligibility, visit www.cms.hhs.gov/immigrants/default.asp.