How long does it take to get approved for CHIP?

How soon will I know if my child is approved for CHIP coverage in Utah?

After you apply for CHIP (Children’s Health Insurance Program) in Utah, you’ll want to know how long it takes to receive a decision about your child’s eligibility. Typically, the Utah Department of Health and Medicaid processes CHIP applications within 30 days. However, the exact time frame can vary depending on the completeness of your application and whether additional documentation is required. Here’s what you need to know about the timeline for CHIP application approval and how you’ll be notified.

1. Typical Processing Time for CHIP Applications

Once you submit your CHIP application, the Utah Medicaid office will generally review and process it within 30 days. During this time, the state will verify your:

• Household income.

• Residency in Utah.

• Citizenship or qualified non-citizen status.

• Other necessary information related to your child’s eligibility.

If there are no issues with the application and all required documentation is submitted, you should receive a decision within this time frame.

2. What Could Delay the Processing Time?

In some cases, the approval process might take longer than 30 days, particularly if:

• You did not submit all the required documents (e.g., proof of income or residency).

• The information provided is incomplete or unclear.

• There is a high volume of applications being processed at the time.

If any additional information or clarification is needed, the Utah Medicaid office will contact you to request the missing documentation. Responding promptly to these requests will help avoid delays.

3. How Will I Be Notified of the Decision?

Once your child’s CHIP application is processed, you will be notified of the decision in one of the following ways:

• By mail: You’ll receive a letter from Utah Medicaid informing you whether your child’s CHIP application has been approved or denied.

• Online: If you applied online, you may also receive an electronic notification through the Utah Medicaid website or healthcare.gov.

The notification will include details about your child’s coverage, when it starts, and how to begin using CHIP benefits if approved.

4. What Happens If My Child Is Approved?

If your child is approved for CHIP coverage:

• You will receive an approval notice with instructions on how to use your child’s CHIP benefits.

• Your child will receive a CHIP benefits card to present when visiting doctors, pharmacies, or other healthcare providers.

• You’ll also receive information about the cost-sharing requirements, such as premiums and copayments, if applicable to your income level.

5. What Happens If My Child’s Application Is Denied?

If your child is not eligible for CHIP, you will receive a denial notice explaining the reason for the decision. Common reasons for denial may include:

• Income exceeds CHIP limits.

• Child is already insured through another plan.

• Incomplete documentation.

If your family’s circumstances change in the future—such as a decrease in income or loss of other health insurance—you can reapply for CHIP at any time. The notice will also provide instructions on how to appeal the decision if you believe your child was wrongly denied coverage.

6. Following Up on Your Application

If you don’t receive a decision within the expected 30-day period, or if you need to check the status of your application, you can:

• Call Utah Medicaid: Contact Utah Medicaid at 1-866-435-7414 to inquire about the status of your child’s CHIP application.

• Check online: If you applied through healthcare.gov or the Utah Medicaid website, you can log into your account to check your application status.

Key Takeaways:

• You will typically receive a decision on your child’s CHIP application within 30 days of submitting a complete application.

• Delays may occur if additional information or documentation is needed, so ensure all required documents are submitted with your application.

• You will be notified of the decision by mail or online, depending on how you applied.

For assistance checking the status of your CHIP application or understanding the approval process, schedule an appointment with a Tsunami Advisor here: Schedule an Appointment.