Free Health Insurance for Kids in Pennsylvania

Pennsylvania offers free health insurance to qualifying low-income or disabled children. Federal and state-funded health care eligibility and benefits are determined by your household size, income, citizenship and medical need. Medically needy or underinsured families and children are encouraged to apply for medical assistance at a local Pennsylvania Department of Public Welfare.

Basic Eligibility

• Public health insurance plans are open to United States citizens and legal aliens residing in Pennsylvania. Children born in the country are U.S. citizens regardless of the mother's citizenship status. Social Security numbers are required for all children applying for assistance. If you do not have a Social Security number, a social worker at the Department of Public Welfare can assist you in applying for one. Proof of residence, income and identity are required. Parental or household income is used to determine benefits after eligible deductions.

Medicaid

• As of 2010, newborns and infants up to age 1 are eligible for free Medicaid coverage if the household income is at or below 185 percent of Federal Poverty Income Guidelines (FPIG). The income limit for children 1 through 5 is 133 percent of FPIG. Children ages 6 to 18 may qualify if the income does not exceed 100 percent of FPIG.

  Children in categorically eligible coverage groups are automatically eligible for free health insurance. Categorically eligible groups include disabled children and those receiving or eligible to receive government cash assistance through Supplemental Security Income, Temporary Assistance for Needy Families or General Assistance. Additionally, children may continue to qualify for Medicaid or Transitional Medicaid if their public assistance was discontinued due to cost of living adjustments or increased child support income.

CHIP

• A child under age 19 whose income exceeds Medicaid limits may receive free health care with the Children's Health Insurance Program. Children must be ineligible for Medicaid and be uninsured to receive CHIP benefits. Previously insured children must be uninsured for at least six months before becoming eligible unless the insurance was terminated due to job loss, the child is changing from one public health program to another or the child is under age 2.

  As of 2010, the annual income limit for free CHIP coverage in a four-person household is $40,793 to $44,100 for a child's first year of life. The income limit for children ages 1 through 5 in the same size family is $29,327 to $44,100. Children ages 6 to 18 qualify for free health insurance if the household income is $22,050 to $44,100 for a family of four.

Coverage

• Medicaid or CHIP benefits and coverage may include free vaccines, doctor visits, specialty services, prescriptions, emergency assistance, dental, vision and mental health services. Health care recipients are responsible for finding out if a physician accepts Medicaid or CHIP prior to treatment.