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KidzPartners Eligibility Guidelines

Who is eligible for CHIP?

Children must meet the following requirements to be eligible for CHIP:

  • Pennsylvania resident
  • U.S. citizen, U.S. national or qualified alien
  • Under age 19
  • Currently uninsured and not eligible for Medical Assistance

If a child is eligible for CHIP, family income will determine whether the child may be enrolled on a free, low-cost or full-cost basis.

  • There are no premiums or copays in the free CHIP program.
  • If your child is enrolled for low-cost or full-cost coverage, you will be required to pay monthly premiums for this coverage, and copays for services received.

How long does coverage last?

CHIP coverage is effective for 12 calendar months. Eligibility for renewal is determined annually. You must reapply for CHIP every year.

How can I learn more about "eligibility review"?

If you have any questions about an eligibility determination, call Member Relations anytime at 1-888-888-1211 (TTY 711).

You should also keep in mind that if your children's circumstances (including family income) change, you can reapply for CHIP coverage or for a different CHIP category.

You have the right to request an impartial review of Health Partners' determination. You may also ask us for a copy of the procedures that our eligibility decision was based on. Reviews are conducted by Health Partners Plan’s Eligibility Review Committee. They include a phone or in-person interview with you and a representative from both Health Partners Plans and the Pennsylvania Insurance Department (PID). 

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