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Revision 25-3; Effective July 1, 2025
CHIP, CHIP Perinatal
Once determined eligible for the Children’s Health Insurance Program (CHIP) or CHIP perinatal, households must complete the enrollment process to receive benefits. The enrollment process includes choosing a health and dental plan and paying an enrollment fee, if applicable.
CHIP
CHIP eligibility is prospective. TIERS provides the potential eligibility begin date and the enrollment broker provides the actual eligibility begin date.
Cutoff rules determine the earliest a child can be eligible for CHIP. When the Eligibility Determination Group (EDG) is disposed on or before the cutoff date, the potential eligibility begin date is the first of the month following the disposition month. When the EDG is disposed after cutoff, the potential eligibility begin date is the first of the second month after the disposition month.
Example 1 – Disposed on or before cutoff:
Disposed May 1, 2015, then eligible June 1, 2015.
Example 2 – Disposed after cutoff:
Disposed May 23, 2015, then eligible July 1, 2015.
Related Policy
Medicaid Termination, A-825
Enrollment Fees at Application, D-1821
Involuntary Disenrollment, D-1761
Denial at Redetermination, A-2342
Eligibility Transition from Medicaid to CHIP, B-123.4
Actions on Changes, B-631
Periodic Income Checks, B-637