Children’s Health Insurance Program
Children in Texas without health insurance may be able to get low cost or no cost health coverage from the Children’s Health Insurance Program (CHIP). El Paso Health helps you to keep your children healthy and happy.
CHIP covers children in families that earn too much money to qualify for Medicaid but cannot afford to buy private insurance. The CHIP Program covers office visits, prescription drugs, dental care, eye exams, glasses, and much more. Families with children with CHIP pay no more than $50 a year for health care coverage. Some families with CHIP also may need to pay co-pays for some services.
CHIP is for children ages 18 and younger who are residents of Texas.
- Checkups (well child visits)
- Shots (Immunizations)
- Prescription medicine
- Specialist care
- Hospital care (inpatient and outpatient)
- Lab tests
- Medical supplies
- Treatment of special health needs
- Treatment of pre-existing conditions
If you child can get CHIP, your enrollment fee and co-pays will be based on your family’s income. Enrollment fees are $50 or less per family, per year. Co-pays for doctor visits and prescriptions range from $5 for lower-income families and $20 to $35 for higher-income families.
Co-payments for medical services or prescription drugs are paid to the health care provider at the time of service. CHIP Perinatal members and CHIP members who are Native American or Alaskan Native are exempt from all cost-sharing obligations, including enrollment fees and co-pays. Additionally, for all CHIP Members there is no cost-sharing on benefits for well-baby and well-child services, preventive services, or pregnancy-related assistance.
Your child’s El Paso Health ID card lists the co-payments that apply to your family situation. Present your child’s ID card when you receive office visit or emergency room services or have a prescription filled.
The Federal Public Health Emergency will end on May 11, 2023.
Starting May 12, 2023, CHIP members will be required to pay copays for office visits again except for the following: • Any services related to COVID – 19. (Vaccines, treatment, testing or treatment of other health issues complicated by COVID)
• Mental Health or Substance Use Disorder office visits.
• Well baby or well child checkups.
• Preventive services.
• Pregnancy-related assistance.
You will need to pay your copays at the time of your visit including ER and inpatient hospital stays.
If you have any questions, please call Member Services at 915 532-3778 or toll free at 877-532-3778.
Well Child Visits are Key to Having a Healthy Child
Well Child visits are an important part of keeping your child healthy. These visits will make sure your child is growing right. They help find problems early, if there are any. And, as a parent, you can know what to expect as your child gets older.
If your child has El Paso Health and is between the ages of, 3-19 years of age, don’t forget to take your child’s birthday reminder card when they see their doctor for a Well-Child visit once a year.
If you need help, please call us today!
915-532-3778 or 1-877- 532-3778