CHIP in Pennsylvania

Pennsylvania at a glance

Pennsylvania is home to about 1,004,975 foreign-born residents (7.7% of the state’s 13,018,639 people) and 1,135,281 residents of Hispanic or Latino origin (8.7%), per the U.S. Census Bureau’s American Community Survey (2024 5-year estimates). The procedures below apply to everyone in Pennsylvania regardless of immigration status unless noted.

CHIP covers health insurance for uninsured children from families earning too much for Medicaid but unable to afford private insurance.

CHIP eligibility limits in Pennsylvania (verified data)

Source: Kaiser Family Foundation (KFF) — CHIP data by state

Verified on: 2026-05-25

Children’s health coverage in Pennsylvania

Child ageMedicaid (% FPL)
Infants 0-1 yearup to 220% FPL
Children 1-5 yearsup to 162% FPL
Children 6-18 yearsup to 138% FPL

CHIP upper income limit in Pennsylvania: 319% of FPL

How to apply for CHIP in Pennsylvania

  1. Combined Medicaid+CHIP application via healthcare.gov
  2. Pennsylvania state application (some states have own portal)
  3. By phone: 1-877-KIDS-NOW (1-877-543-7669)

Pennsylvania adopted CHIPRA Option

Pennsylvania adopted the CHIPRA option, eliminating the 5-year bar for permanent-resident children. This means a child with a new green card (under 5 years in US) can qualify for CHIP in Pennsylvania without waiting.

How to apply for CHIP in Pennsylvania

  1. Visit Healthcare.gov or Pennsylvania’s Medicaid/CHIP portal
  2. Complete the application — ONE application covers both Medicaid AND CHIP automatically
  3. Pennsylvania determines if your child qualifies for one or the other

Typical coverage

State CHIP plans cover doctor visits, vaccines, hospitalization, prescriptions and mental health care. Dental is required by federal law — coverage of dental services “necessary to prevent disease and promote oral health, restore oral structures to health and function, and treat emergency conditions” (42 U.S.C. 1397cc(c)(6)(A)). Vision and hearing are not required. The statute puts prescription drugs, vision services and hearing services in a separate list of “categories of additional services” (42 U.S.C. 1397cc(c)(2)). Whether your state’s CHIP covers eye exams and glasses is a state benefit choice, not a federal guarantee.

Income limits

Generally 200-300% federal poverty level. Against the 2026 HHS poverty guidelines, 100% of the poverty level for a household of four in the 48 contiguous states and DC is $33,000 , so a 200-300% range is about $66,000 -$99,000 a year. The limit that decides your case is the state figure in the table above.

Costs

CHIP has low co-pays (sometimes $0) and, in states that charge them, low monthly premiums; federal rules cap a family’s total CHIP cost-sharing at 5% of its income over the child’s eligibility period (42 CFR 457.560).

Last verified: 2026-09-24.