CHIP & Medicaid Programs

A substantial number of people in the U.S. cannot afford private insurance and are left to take care of their medical expenses alone. Children make up a large number of the nation's uninsured. According The Children's Health Insurance Program Re-authorization Act of 2009, millions of children are lacking basic health care. The Act was passed to help ensure that children's health-care needs were being met. Medicaid is another Federal program that helps many low-income people obtain much-needed health care, such as dental, prenatal and disability needs.

CHIP Medical Insurance Program

• The Children's Health insurance program provides subsidized health care to children nationwide. Over the last 10 years, the program has spent about $20 billion to insure low-income children who are not eligible for Medicaid but cannot afford private insurance. This program is distributed by the states, and each state has its own CHIP policies. Most states have income restrictions. Some, such as Pennsylvania, do not have income restrictions, but higher-income households in these states will still pay monthly for coverage. In order to be eligible, an applicant must be under 19, a U.S. citizen or qualified alien, a resident of the state in which she is applying, and uninsured. Guardians of applicants must apply through their local state agencies for consideration.

  U.S. Department of Health & Human Services

  200 Independence Avenue SW

  Washington, D.C. 20201

  Insurekidsnow.gov

CHIP Dental Program

• CHIP provides programs for dental care.

  Dental programs within CHIP are available to children 19 or under who are from low-income families and cannot find coverage anywhere else. The dental programs are administered on a state-by-state basis and may have different program specifics in each state. Dental services are categorized as preventive or therapeutic. All children under the CHIP dental program are eligible for both types of services; however, states may regulate the yearly allowance for each type. Preventive care includes routine checkups and cleanings, x-rays, and sealants to prevent tooth decay, while therapeutic services includes fillings, extractions, crowns/caps and root canals.

  Each state has its own maximum coverage amount per year; for example, in Texas, the maximum coverage for preventive dental care in a 12-month period is $175. The coverage amount for therapeutic services is determined by the state, and generally depends on factors such as application renewal time, child enrollment period and enrollment fee payments. Individuals can apply for CHIP dental programs through local state social service agencies or social workers.

  U.S. Department of Health & Human Services

  200 Independence Avenue SW

  Washington, D.C. 20201

  Insurekidsnow.gov

Medicaid Program

• Medicaid is a federal health insurance program for low-income individuals and families that fall within certain eligibility requirements. Members of the program are able to obtain health services by seeing approved health-care providers, who then send the patient's bills to Medicaid for payment. Each state has its own regulations and policies regarding Medicaid, such as eligibility requirements, coverage amount, accepted health providers and services. Applicants must be U.S. citizens or lawful immigrants, and must display financial hardship according to the income restrictions of the state program; they may also need to fulfill other eligibility restrictions, depending on the state. Potential applicants should contact their local state social services agency to find out specific details of their local program.

  Centers for Medicare & Medicaid Services

  7500 Security Boulevard

  Baltimore, MD 21244

  410-786-3000

  Cms.gov

Medicaid Drug Rebate Program

• The Medicaid drug rebate program is a national agreement between pharmaceutical manufacture companies and the Department of Health and Human Services. The purpose of this program is to allow drugs to be more affordable for states that administer Medicaid services. In order to participate, the drug company must enter into agreements that will regulate the cost of drugs covered by Medicaid. Once the drug company and the department agree on the cost of the drug, it will become available to Medicaid members. As part of the agreement, the company will send drug rebates to Medicaid agencies for drugs used by Medicaid members. According to the department, 550 pharmaceutical companies and 49 states participate in the program. The purpose of the program is to allow drug companies to participate in the Medicaid program, reducing program costs for states and making access to quality drugs easier for low-income people. Interested companies should contact their local Medicaid office for application details.

  Department Of Health & Human Services

  Centers for Medicare & Medicaid Services

  7500 Security Boulevard, Mail Stop S2-26-12

  Baltimore, Maryland 21244-1850

  410-786-3325

  Nga.org