The Pennsylvania Children’s Health Insurance Program (CHIP) offers quality, affordable health coverage for uninsured children and teens in Pennsylvania who are not eligible for Medicaid.

Yes. Jefferson Health Plans proudly offers CHIP coverage for Pennsylvania families.

Jefferson Health Plans has offered CHIP coverage since 2012.

Jefferson Health Plans CHIP is available in all Pennsylvania counties.

CHIP covers children and teens in families who earn too much for Medicaid but still need affordable health insurance.

Children and teens up to age 19 who are residents of Pennsylvania and meet income guidelines may qualify for CHIP.

CHIP covers children and teens from birth through age 19.

Yes. Many working families qualify for CHIP based on household income.

Income limits vary by family size. Most families qualify for free or low-cost coverage. Visit COMPASS or call Member Services for help checking eligibility.

CHIP is available to U.S. citizens and certain lawfully residing children.

Yes, lawfully residing immigrant children may qualify for CHIP.

You can apply online through COMPASS, via the MyCOMPASS PA app, or through the CHIP helpline at 1-800-986-KIDS (5437). You can also apply at your local county assistance office. Visit our How to Enroll page for more information.

Visit COMPASS online or contact Jefferson Health Plans for help determining eligibility.

Yes. If your income increases, your child may move from Medicaid to CHIP without losing coverage. Visit COMPASS for more information.

Yes. All eligible children in your household can be enrolled in CHIP.

CHIP covers doctor visits, hospital care, prescriptions, dental, vision, and behavioral health services.

Yes. Preventive care, including annual checkups and immunizations, is fully covered.

Yes. CHIP includes dental exams, cleanings, eyeglasses, and vision exams.

Yes. CHIP includes prescription drug coverage.

Routine checkups, vaccines, screenings, and health education are all included.

Yes. CHIP covers counseling, therapy, and behavioral health care for children and teens. 

Yes. Jefferson Health Plans offers care coordination and support for children with chronic or special health needs. These services are voluntary and are offered at no charge to members.

Some families may have small copays or monthly premiums based on income, but many qualify for free coverage.

You can contact Jefferson Health Plans Member Services for help with bringing your account up to date to avoid a lapse in coverage.

Information about monthly premiums for our CHIP plans can be found here.

Yes. CHIP members can use telehealth for convenient access to doctors and specialists. Learn more about getting care here.

Use our online provider directory or call Member Services at 1-888-888-1211 for assistance.

In most cases, yes. Your child’s primary care provider (PCP) can provide a referral.

If your doctor is in the Jefferson Health Plans network, you can stay with them. To see if your doctor is in the Jefferson Health Plans provider network, you can:

1. Ask your child’s doctor’s office.
2. Search for them within our online provider directory located here.
3. Call Member Services at 1-888-888-1211 and ask to see if their existing doctor is in our network or help finding a new doctor.

You can change your child’s PCP anytime by calling Member Services at 1-888-888-1211 or by logging in to the member portal.

Visit our online provider directory here or contact Member Services at 1-888-888-1211 for help finding dental and vision providers.

Yes. Our network includes pediatric specialists for a wide range of health needs.

CHIP coverage must be renewed once a year to stay active.

You’ll receive a notice by mail, email, or text from the Pennsylvania Department of Human Services (DHS) when it’s time to renew. To ensure you receive a notice when it’s time to renew, make sure to update your contact information in your COMPASS account so that it is always up to date. 

If you miss your renewal date, your child’s coverage could end. Contact Jefferson Health Plans or Pennsylvania DHS right away to reinstate coverage.

Report changes to your local county assistance office or update your information through COMPASS.

Yes. If your child is still eligible, you can re-enroll at any time by visiting COMPASS.

If you move within Pennsylvania, you can stay with Jefferson Health Plans CHIP. If you move out of state, you’ll need to apply for coverage in your new state.

Call Member Services at 1-888-888-1211 or check our online formulary to see if your medication is covered.

You can fill prescriptions at any pharmacy in our network. Find one here.

Yes. Mail-order delivery is available for many maintenance medications through Caremark.

Your doctor will submit a prior authorization request, and Jefferson Health Plans will review it quickly.

Call your pharmacy or Jefferson Health Plans Member Services at 1-888-888-1211 right away for help with refills or temporary supplies.

Go to the nearest emergency room or call 911. CHIP covers all emergency services.

Yes. CHIP covers urgent care visits for illnesses or injuries that need quick attention.

No. You do not need approval for emergency services.

Yes. CHIP members can access 24/7 nurse advice and telehealth services for non-emergency care.

Log in to the member portal or call Member Services at 1-888-888-1211 to request a replacement card.

Sign in to your secure member portal here to view claims and benefits.

Yes. Jefferson Health Plans provides free interpreter services for members who need language support. Call Member Services at 1-888-888-1211 for help.

Jefferson Health Plans CHIP families can access programs, including fitness and family activities, at any of our Community Wellness Centers. Find out more by going to our Community Engagement page.

Call Member Services at 1-888-888-1211 or email contact@JeffersonHealthPlans.com for assistance.

Yes. CHIP covers newborns and infants who meet eligibility guidelines.

Yes. CHIP covers all required vaccines at no cost to families.

When your child turns 19, they may qualify for adult coverage through Pennie.com.

Yes. Jefferson Health Plans offers assistance with coordinating your child’s special healthcare needs and other services that can affect their health and wellness.

Update your address right away through COMPASS or by calling Member Services at 1-888-888-1211.

Emergency care is covered nationwide. For non-emergencies, call Member Services at 1-888-888-1211 before traveling.