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Medicaid and the Children’s Health Insurance Program (CHIP)

Offer Free Or Low-Cost Health Coverage To Children And Families

If you are eligible for health coverage from your employer, but are unable to afford the premiums,

some States have premium assistance programs that can help pay for coverage. These States use

funds from their Medicaid or CHIP programs to help people who are eligible for employer-

sponsored health coverage, but need assistance in paying their health premiums.

If you or your dependents are already enrolled in Medicaid or CHIP and you live in a State listed

below, you can contact your State Medicaid or CHIP office to find out if premium assistance is

available.

If you or your dependents are NOT currently enrolled in Medicaid or CHIP, and you think you or

any of your dependents might be eligible for either of these programs, you can contact your State

Medicaid or CHIP office or dial 1-877-KIDS NOW or www.insurekidsnow.gov to find out how to

apply. If you qualify, you can ask the State if it has a program that might help you pay the

premiums for an employer-sponsored plan.

Once it is determined that you or your dependents are eligible for premium assistance under

Medicaid or CHIP, your employer’s health plan is required to permit you and your dependents to

enroll in the plan – as long as you and your dependents are eligible, but not already enrolled in the

employer’s plan. This is called a “special enrollment” opportunity, and you must request

coverage within 60 days of being determined eligible for premium assistance.

If you live in one of the following States, you may be eligible for assistance paying your

employer health plan premiums. The following list of States is current as of January 31, 2011.

You should contact your State for further information on eligibility –

ALABAMA – Medicaid

CALIFORNIA – Medicaid

Website: http://www.medicaid.alabama.gov

Phone: 1-800-362-1504

Website: http://www.dhcs.ca.gov/services/Pages/

TPLRD_CAU_cont.aspx

Phone: 1-866-298-8443

ALASKA – Medicaid

COLORADO – Medicaid and CHIP

Website: http://health.hss.state.ak.us/dpa/programs/medicaid/

Phone (Outside of Anchorage): 1-888-318-8890

Phone (Anchorage): 907-269-6529

Medicaid Website: http://www.colorado.gov/

Medicaid Phone (In state): 1-800-866-3513

Medicaid Phone (Out of state): 1-800-221-3943

CHIP Website: http:// www.CHPplus.org

CHIP Phone: 303-866-3243

ARIZONA – CHIP

Website: http://www.azahcccs.gov/applicants/default.aspx

Phone (Outside of Maricopa County): 1-877-764-5437

Phone (Maricopa County): 602-417-5437

ARKANSAS – CHIP

FLORIDA – Medicaid

Website: http://www.arkidsfirst.com

Phone: 1-888-474-8275

Website: http://www.fdhc.state.fl.us/Medicaid/index.shtml

Phone: 1

-877-357-3268

GEORGIA – Medicaid

MISSOURI – Medicaid

Website: http://dch.georgia.gov/

Click on Programs, then Medicaid

Phone: 1-800-869-1150

Website:

http://www.dss.mo.gov/mhd/participants/pages/hipp.htm

Phone: 573-751-2005

IDAHO – Medicaid and CHIP

MONTANA – Medicaid

Medicaid Website: www.accesstohealthinsurance.idaho.gov

Medicaid Phone: 1-800-926-2588

CHIP Website: www.medicaid.idaho.gov

CHIP Phone: 1-800-926-2588

Website: http://medicaidprovider.hhs.mt.gov/clientpages/

clientindex.shtml

Phone: 1-800-694-3084

INDIANA – Medicaid

NEBRASKA – Medicaid

Website: http://www.in.gov/fssa

Phone: 1-800-889-9948

Website: http://www.dhhs.ne.gov/med/medindex.htm

Phone: 1-877-255-3092

IOWA – Medicaid

NEVADA – Medicaid and CHIP

Website: www.dhs.state.ia.us/hipp

Phone: 1-888-346-9562

/ Me

dicaid Website: http://dwss.nv.gov/

dicaid Phone: 1-800

-992-0900

CHIP Website: http://www.nevadacheckup.nv.org/

CHIP Phone: 1-877-543-7669

KANSAS – Medicaid

Website: https://www.khpa.ks.gov

Phone: 1-800-792-4884

KENTUCKY – Medicaid

NEW HAMPSHIRE – Medicaid

Website: http://chfs.ky.gov/dms/default.htm

Phone: 1-800-635-2570

Website: www.dhhs.nh.gov/ombp/index.htm

Phone: 603-271-4238

LOUISIANA – Medicaid

NEW JERSEY – Medicaid and CHIP

Website: http://www.lahipp.dhh.louisiana.gov

Phone: 1-888-342-6207

Medicaid Website: http://www.state.nj.us/humanservices/

dmahs/clients/medicaid/

Medicaid Phone: 1-800-356-1561

CHIP Website: http://www.njfamilycare.org/index.html

CHIP Phone: 1-800-701-0710

MAINE – Medicaid

Website: http://www.maine.gov/dhhs/OIAS/public-

assistance/index.html

Phone: 1-800-321-5557

MASSACHUSETTS – Medicaid and CHIP

NEW MEXICO – Medicaid and CHIP

Medicaid & CHIP Website:

http://www.mass.gov/MassHealth

Medicaid & CHIP Phone: 1-800-462-1120

Medicaid Website:

http://www.hsd.state.nm.us/mad/index.html

Medicaid Phone: 1-888-997-2583

CHIP Website:

http://www.hsd.state.nm.us/mad/index.html

Click on Insure New Mexico

CHIP Phone: 1-888-997-2583

MINNESOTA – Medicaid

Website: http://www.dhs.state.mn.us/

Click on Health Care, then Medical Assistance

Phone (Outside of Twin City area): 800-657-3739

Phone (Twin City area): 651-431-2670

NEW YORK – Medicaid

TEXAS – Medicaid

Website: http://www.nyhealth.gov/health_care/medicaid/

Phone: 1-800-541-2831

Website: https://www.gethipptexas.com/

Phone: 1-800-440-0493

NORTH CAROLINA – Medicaid

UTAH – Medicaid

Website: http://www.nc.gov

Phone: 919-855-4100

Website: http://health.utah.gov/upp

Phone: 1-866-435-7414

NORTH DAKOTA – Medicaid

VERMONT– Medicaid

Website:

http://www.nd.gov/dhs/services/medicalserv/medicaid/

Phone: 1-800-755-2604

Website: http://www.greenmountaincare.org/

Phone: 1-800-250-8427

OKLAHOMA – Medicaid

VIRGINIA – Medicaid and CHIP

Website: http://www.insureoklahoma.or

Phone: 1-888-365-3742

Medicaid Website: http://www.dmas.virginia.gov/rcp-

HIPP.htm

Medicaid Phone: 1-800

-432-5924

CHIP Website: http://www.famis.org/

CHIP Phone: 1-866-873-2647

OREGON – Medicaid and CHIP

WASHINGTON – Medicaid

Medicaid & CHIP Website:

http://www.oregonhealthykids.gov

Medicaid & CHIP Phone: 1-877-314-5678

Website:

http://hrsa.dshs.wa.gov/premiumpymt/Apply.shtm

Phone: 1-800-562-3022 ext. 15473

PENNSYLVANIA – Medicaid

WEST VIRGINIA – Medicaid

Website:

http://www.dpw.state.pa.us/partnersproviders/medicalassista

nce/doingbusiness/003670053.htm

Phone: 1-800-644-7730

Website: http://www.wvrecovery.com/hipp.htm

Phone: 304-342-1604

RHODE ISLAND – Medicaid

WISCONSIN – Medicaid

Website: www.dhs.ri.gov

Phone: 401-462-5300

Website: http://www.badgercareplus.org/pubs/p-10095.htm

Phone: 1-800-362-3002

SOUTH CAROLINA – Medicaid

WYOMING – Medicaid

Website: http://www.scdhhs.gov

Phone: 1-888-549-0820

Website:

http://www.health.wyo.gov/healthcarefin/index.html

Phone: 307-777-7531

To see if any more States have added a premium assistance program since January 31, 2011, or for

more information on special enrollment rights, you can contact either:

U.S. Department of Labor U.S. Department of Health and Human Services

Employee Benefits Security Administration Centers for Medicare & Medicaid Services

www.dol.gov/ebsa www.cms.hhs.gov

1-866-444-EBSA (3272) 1-877-267-2323, Ext. 61565

OMB Control Number 1210-0137 (expires 09/30/2013)

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