Costs for CHIP
Coverage is free or low cost, based on your household income.
What does CHIP cost?
This comprehensive coverage is offered at low or no cost and no family makes too much money.
Most families can receive CHIP coverage for free. Others can get the same benefits at a low cost, depending on household size and income. There are 3 main categories of CHIP coverage:
- Free CHIP: There are no required monthly premium payments and no copays for covered services.
- Low-cost CHIP: Payment of a modest monthly premium that is a portion of the total cost of health insurance coverage is required, and there are copays for some covered services.
- Full-cost CHIP: Payment of a monthly premium that covers the total cost of health insurance coverage is required, and there are copays for some covered services.
Income chart
Use the CHIP income chart below to help determine what cost (if any) is associated with CHIP coverage for your child:
- In the household size section, locate the number of people in your household.
- Find the range that matches the age of your children and your household's annual gross income.
- Look down the row in the cost section to see the approximate, average monthly premium cost per child and copayments for doctor visits, drugs and more.
If your family income is too low for CHIP, your child may be enrolled in Medicaid. Learn more about GHP Family, our plan for Medical Assistance recipients.
Visit costs
Well-child PCP visit
| Visit type | Cost | |
| Free CHIP | $0 | |
| Low-cost CHIP | $0 | |
| Full-cost CHIP | $0 |
Other PCP visit
| Visit type | Cost | |
| Free CHIP | $0 | |
| Low-cost CHIP | $5 | |
| Full-cost CHIP |
$15 |
Specialist visit
| Visit type | Cost | |
| Free CHIP | $0 | |
| Low-cost CHIP | $10 | |
| Full-cost CHIP |
$25 |
Emergency department
| Visit type | Cost | |
| Free CHIP | $0 | |
| Low-cost CHIP | $25 (waived if admitted) | |
| Full-cost CHIP |
$50 (waived if admitted) |
Urgent care visit
| Visit type | Cost | |
| Free CHIP | $0 | |
| Low-cost CHIP | $10 | |
| Full-cost CHIP |
$25 |
Contact us
Have questions? Our customer care team is happy to help. We're available: Monday – Friday: 7 a.m. – 7 p.m. | Saturday: 8 a.m. – 2 p.m.
Call
Call us at 866-621-5235
(PA Relay: 711).