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Frequently Asked Questions

Important changes to your children’s CHIP eligibility process

Currently, your CHIP health insurance company processes all applications, renewals, and changes to your CHIP coverage. Starting April 17, 2023, the Pennsylvania Department of Human Services (DHS) will begin determining eligibility for CHIP applications and renewals. DHS will also handle all communications related to eligibility and application/renewal processing.

FAQ about eligibility processing changes (PDF)

CHIP eligibility

What is CHIP?

CHIP is short for the Children’s Health Insurance Program. CHIP is a state and federally funded program that provides comprehensive health insurance to uninsured children and teens up to age 19 who are not eligible for Medical Assistance. If you know a child who needs health insurance, CHIP, brought to you by UPMC for Kids, can help.

Who gets CHIP coverage?

Uninsured children (younger than 19 years old) who are not eligible for or enrolled in Medical Assistance can receive coverage. You can learn more on our Eligibility page.

Can I make too much money to enroll my child with CHIP?

No. Your child can still be enrolled with CHIP no matter how high your family income. However, if your income is found to be below the income guidelines for the CHIP program, your child may be enrolled in Medical Assistance.

Are children with pre-existing conditions eligible?

Yes. There are no exclusions for pre-existing conditions for CHIP or Medical Assistance. However, if your child has a serious medical condition or disability, they may be eligible for Medical Assistance.

If my child has health insurance through my employer, can I still get CHIP?

No. Children cannot have any other health insurance and be enrolled in CHIP. If your child is enrolled in CHIP coverage and gains private insurance, contact DHS right away by calling the DHS Statewide Customer Service Center at 1-877-395-8930 (215-560-7226 in Philadelphia) Monday through Friday from 8 a.m. to 4:30 p.m.

What is the UPMC for Kids service area?

We serve 64 counties in Pennsylvania. View our Eligibility page to see if UPMC for Kids provides coverage in your area.

Applying for CHIP coverage

How can I apply for CHIP coverage?

Parents or legal guardians can apply for CHIP for their children by applying online at www.compass.state.pa.us, through your myCOMPASS PA mobile app, by calling UPMC for Kids, or by completing a paper application. Visit our Enroll page to learn more.

Whose income should I include on the application?

CHIP has rules about who is included when determining eligibility. Give information, including income, for anyone who lives with you. Also, anyone whom you expect to be included on your tax return—even if they do not live with you. For more information, call UPMC for Kids at 1-800-978-8762, Monday through Friday from 8 a.m. to 6 p.m. TTY users should call 711.

Who will be processing my application?

Effective April 17, 2023, the Pennsylvania Department of Human Services (DHS) began determining eligibility for CHIP applications and renewals. DHS also handles all communications related to eligibility and application/renewal processing.

How can I check the status of my application?

If you would like to check the status of your application once you have submitted it, you can log in to your COMPASS account online, or through your myCOMPASS PA mobile app. You can also call the DHS Statewide Customer Service Center at 1-877-395-8930 (215-560-7226 in Philadelphia) Monday through Friday from 8 a.m. to 4:30 p.m.

How will I be notified of my child’s eligibility?

Once your application has been completed, DHS will notify you of the outcome by mail. You can also sign up to receive electronic notifications by logging in to your COMPASS account online.

Does CHIP have a waiting list?

No. There is no waiting list to enroll in CHIP.

How long do children stay covered?

If children continue to meet CHIP’s eligibility requirements, they can be covered up to age 19. Eligibility is reviewed every 12 months during renewal.

Renewing coverage

How can I renew coverage?

Ready to renew UPMC for Kids coverage for your child? Renewals can be completed by logging into your COMPASS account, through your myCOMPASS PA mobile app, or by calling us at 1-800-978-8762, and we can help you get started. To learn more, visit our How to Renew page.

How can I check the status of my renewal?

If you would like to check the status of your renewal, log in to your COMPASS account online or your myCOMPASS PA mobile app. You can also call the DHS Statewide Customer Service Center at 1-877-395-8930 (215-560-7226 in Philadelphia) Monday through Friday from 8 a.m. to 4:30 p.m. When the renewal is completed, DHS will notify you by mail. You can also sign up to receive electronic notifications by logging in to your COMPASS account.

Benefits

What does UPMC for Kids cover?

UPMC for Kids includes medical, dental, vision, prescription, and behavioral health coverage. For more details, you can visit our Benefits page.

Does UPMC for Kids cover emergencies?

With UPMC for Kids, your child is covered for emergencies at any hospital within the United States. If your child is enrolled in a CHIP group that requires copayments, you do not need to pay the emergency room copay if your child is admitted to the hospital.

How do I order a new or duplicate ID card?

There are several ways to request an ID card.

  • Online: Sign in or register for MyHealth OnLine to print a temporary copy of your child’s ID card. You can also chat with a representative to request a new card.
  • Call: Call us at 1-800-650-8762 (TTY: 711). Help is available Monday through Friday from 8 a.m. to 6 p.m. and Saturday, 8 a.m. to 12 p.m.
How do I update my child’s primary care physician (PCP)?

If you’d like to update your child’s PCP, you can log in to MyHealth OnLine and click on Select or Update Your Primary Care Provider. You can also contact the UPMC for Kids Health Care Concierge team by calling 1-800-650-8762. Once you have updated the PCP, you will receive a new member ID card in the mail with the new PCP group name.

Premiums

Will I need to pay a monthly premium for my child’s coverage?

Based on family income, your child may be enrolled in free CHIP, low-cost CHIP, or full-cost CHIP. Many families are eligible to receive CHIP at no cost. Families with higher incomes will have low monthly premiums and copayments for some services. Families with incomes below the CHIP threshold may be eligible for Medical Assistance.

Visit our Eligibility page to learn more about CHIP income guidelines and premium rates in your area. You can also call us at 1-800-978-8762. We're happy to help.

How can I make payments?

You can pay your child's insurance premiums online by signing in to or registering for MyHealth OnLine. You can also call 1-800-650-8762 (TTY: 711) to use our secure automated system 24/7.

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