Keystone HMO CHIP: Affordable Health Insurance for Children in Pennsylvania

By August 2, 2021September 13th, 2021Benefits Enrollment Health Insurance Member Resources
A pediatrician having a check up on his patient

Parents have so many things to worry about. Getting affordable health insurance for their children shouldn’t have to be one of them. For many families, Keystone HMO Children’s Health Insurance Program (CHIP) coverage may be the solution.

IBX CHIP insurance in PA provides affordable, comprehensive coverage for children through age 19 whose parents meet eligibility requirements and live in Bucks, Chester, Delaware, Montgomery, and Philadelphia counties.

Chart of the benefits included with Keystone HMO CHIP coverage: Doctor office visits, dental, diagnostic tests, emergency care, hospitalization, lab work & X-rays, prescription drugs, eye care & eyeglasses, durable medical equipment, hearing care, immunizations, behavioral health & substance use services

How Much Does Keystone HMO CHIP Cost?

Keystone HMO CHIP monthly premiums depend on household size and income, and range from No Cost to Low Cost to Full Cost options. View our Keystone HMO CHIP premium information.

  • Low-cost Keystone HMO CHIP*: $45.00, $88.42, or $101.05 per child per month
  • Full-cost Keystone HMO CHIP*: $340.76 per child per month

How Does Keystone HMO CHIP Work?

Medical benefits are provided through the Keystone HMO CHIP network of physicians and hospitals, dental benefits are provided by United Concordia and routine vision benefits, including coverage for eye wear and lenses, are provided by Davis Vision. Find a provider.

What is the Difference Between Keystone HMO CHIP and Medicaid? 

  • Medicaid is health coverage for individuals, including children, pregnant women, parents, and seniors who meet certain maximum income thresholds or have certain disabilities.
  • Keystone HMO CHIP provides health coverage for children and teens up to age 19 in families with incomes too high to qualify for Medicaid, and who find Keystone HMO CHIP is a great alternative to no insurance or their group insurance options. No family earns too much to enroll their child in Keystone HMO CHIP coverage.

How to Apply for Keystone HMO CHIP

If you meet PA CHIP eligibility requirements, you can apply:

If you need help, please call the Keystone HMO CHIP Member Help Team at 1-800-464-5437 (TTY/TDD: 711). Ver esta información en español.

Not Eligible for Keystone HMO CHIP? 

If your child is not eligible for Keystone HMO CHIP, you will be notified in writing as to why your child is not eligible.

If your child appears to be eligible for Medicaid, your child’s application will be forwarded to the County Assistance Office, and you will get a letter within 30 days telling you the application status and next steps to take.

If you are not eligible for Medicaid, your child may be eligible for Keystone HMO CHIP. Or you may be eligible for financial assistance, also called subsidies, to reduce your monthly rate. Check the Tax Credit Calculator on ibx.com to see if you and your family are eligible.

*The premium for three or more children is three times (3x) the per-child monthly premium.
Kortney Cruz

About Kortney Cruz

As Vice President of Sales and Marketing for Medicare at Independence Blue Cross, Kortney is a long-time leader accountable for marketing Medicare and CHIP products and services to the communities we serve, and helping those communities enroll into the Medicare and CHIP coverage they need. She is directly responsible for acquisition and member retention marketing, product development, sales operations and sales management at Independence in the Medicare and CHIP area. Her goal is to deliver innovative and value driven communications, and she is passionate about enriching the connection between Independence Blue Cross and our membership.