Is my child eligible for CHIP in Utah?

What are the income limits and other criteria to qualify my child for CHIP in Utah?

The Children’s Health Insurance Program (CHIP) in Utah provides low-cost health coverage for children in families that earn too much to qualify for Medicaid but still struggle to afford private health insurance. CHIP ensures that children have access to essential medical services such as doctor visits, hospital stays, prescriptions, dental care, and more. Here’s an overview of the income limits and eligibility criteria to qualify your child for CHIP in Utah.

1. Income Limits for CHIP in Utah

Eligibility for CHIP is determined by household income and is based on a percentage of the Federal Poverty Level (FPL). To qualify for CHIP in Utah, your household income must fall between 138% and 200% of the FPL.

Here are the 2024 income limits for CHIP based on household size:

Household Size138% of FPL (Minimum Income)200% of FPL (Maximum Income)1$20,120$29,1602$27,214$39,4403$34,307$49,7204$41,400$60,000

• For larger households, the income limits increase accordingly.

• If your income is below 138% of the FPL, your child may qualify for Medicaid instead of CHIP.

2. Other Eligibility Criteria for CHIP in Utah

In addition to meeting the income requirements, there are other criteria your child must meet to qualify for CHIP coverage in Utah:

A. Age Requirement

• CHIP covers children under the age of 19. Once your child turns 19, they will no longer be eligible for CHIP coverage.

B. Residency Requirement

• Your child must be a resident of Utah. You will need to provide proof of Utah residency, such as a utility bill or lease agreement, when applying.

C. Citizenship or Immigration Status

• Your child must be a U.S. citizen or a qualified non-citizen (such as a lawful permanent resident) to be eligible for CHIP. Non-citizens must provide proof of legal residency, such as a green card.

D. Health Insurance Status

• Your child must be uninsured to qualify for CHIP. If your child has access to affordable employer-sponsored health insurance, they may not be eligible for CHIP.

• If your child has lost health coverage due to a change in your employment or financial situation, they may qualify for CHIP.

3. CHIP Coverage and Benefits

Children enrolled in CHIP receive comprehensive healthcare coverage, including:

• Doctor visits: Routine checkups, preventive care, and immunizations.

• Hospital services: Inpatient and outpatient hospital care.

• Prescription drugs: Coverage for necessary medications.

• Dental and vision care: Routine dental checkups, cleanings, and eye exams.

• Mental health services: Counseling, therapy, and psychiatric care.

CHIP offers similar coverage to Medicaid, but the program is specifically designed for families with moderate incomes.

4. Premiums and Copayments for CHIP

While CHIP offers affordable coverage, families may be required to pay small monthly premiums and copayments for services. The amount depends on your household income and family size:

• Premiums: CHIP premiums are generally lower than private insurance costs and are based on a sliding scale.

• Copayments: Families may have to pay small copays for doctor visits, prescriptions, and other services, but there are annual out-of-pocket limits to ensure costs remain affordable.

5. How to Apply for CHIP in Utah

If you meet the income and eligibility criteria, you can apply for CHIP by following these steps:

• Apply online: Visit medicaid.utah.gov or healthcare.gov to submit an online application for CHIP.

• Apply in person: You can also apply at your local Department of Workforce Services (DWS) office in Utah.

• Submit documentation: You’ll need to provide proof of income, residency, and citizenship or immigration status when applying.

6. Renewing CHIP Coverage

CHIP coverage must be renewed annually. You will need to submit updated information about your household income and any changes in your family’s circumstances. If your income changes, your child may transition to Medicaid or other healthcare programs.

Key Takeaways:

• To qualify for CHIP in Utah, your household income must be between 138% and 200% of the Federal Poverty Level (FPL).

• Your child must be under 19 years old, a resident of Utah, and a U.S. citizen or qualified non-citizen.

• CHIP offers comprehensive healthcare coverage, including doctor visits, hospital services, prescription drugs, dental care, and vision care.

• Families may be required to pay small premiums and copayments based on their income, with annual out-of-pocket limits to keep costs manageable.

For assistance determining if your child qualifies for CHIP and help with the application process, schedule an appointment with a Tsunami Advisor here: Schedule an Appointment.