CHIP Overview

Texas CHIP Plan Overview

Children’s Health Insurance Program (CHIP) provides low-cost health coverage to families that earn too much to qualify for Medicaid but can’t afford to buy health insurance through an exchange. CHIP Perinatal extends this same coverage to expecting moms who don’t qualify for Medicaid but whose income is less than 200% of the Federal Poverty Level (FPL).

Children's Health Insurance Plan

CHRISTUS Health Plan provides this coverage to people who qualify in our Texas service area. Through CHIP, you can pick a doctor close to you, get free or low-cost health education classes and many more benefits.

For those who are already members and would like to file a CHIP Complaint, please see our Complaints & Appeals section.

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Responsive Table
Medical Benefits for Traditional CHIP Plan
Who's Eligible What's Covered
Kids 18 and under
  • Doctor visits and routine check-ups
  • Immunizations
  • Prescriptions
  • Dental care
  • Eye exams and glasses
  • Hearing exams
  • Inpatient and outpatient care
  • Emergency care
  • Mental health services
  • Interpretations services
  • Labs and x-rays
  • Rides to the doctor
Responsive Table
Medical Benefits for CHIP Perinatal
Who's Eligible What's Covered
Pregnant women
  • Up to 20 doctor visits
  • Prenatal vitamins
  • Prescriptions
  • Labor and delivery
  • Up to two follow-up visits for mom after the baby is born
  • Regular check-ups, vaccines, and prescriptions for the baby after mom leaves the hospital

Note: Some services may need prior approval before you get them.

CHRISTUS Health Plan provides the following value added services:

  • 24/7 nurse helpline at 1-844-581-3173
  • Smoking cessation program
  • Home visits to high-risk pregnant members who are enrolled in care management
  • Home environment assessments to those in care or disease management programs
  • Free member newsletter
  • Benefits toward contact lenses for members 12-18 years of age
  • Sports physical exams for members age 19 and younger
  • PROMISE program, which provides a free package of diapers ($50 value) to a pregnant member who completes ten prenatal and one postpartum doctor visits
  • Care management, a free program for those with chronic illnesses. Nurses will help coordinate your care and answer questions (only for CHRISTUS Health Plan CHIP Perinatal program members).

Co-payments are waived for services provided August 25, 2017 through November, 30, 2017 for members with a permanent address in one of the Hurricane Harvey Federal Emergency Management Agency (FEMA) declared disaster counties. Please see attached Notice from Texas Health and Human Services CHIP.

For CHIP plans, you may need to provide a copayment when your child receives certain covered services. You will not need to pay a copay for well-child visits or immunizations, and copayments do not apply to CHIP perinatal or newborn members.

Copayments are determined in the CHIP cost-sharing table (PDF) by income, and your child’s ID card will list the copayment amount. Copayments are due at the time of service; make sure to show your child’s ID card at office visits, the ER or at the pharmacy when you have a prescription filled.

For more information on CHIP and how to apply, call us at 1-800-359-5613 (1-800-735-2989 for deaf or hard of hearing members).

Last updated: 2/23/17