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      3. CHIP Eligibility and Costs

      CHIP - Highmark Healthy Kids Eligibility and Costs

      Am I eligible?

      Most children receive CHIP - Highmark Healthy Kids for free. For children who live in a household with a higher income, out-of-pocket costs like monthly premiums and copays may apply.

      Your children are eligible if they're:

      • under 19 years of age.
      • A U.S. citizen, U.S. national, or a qualified legal resident.
      • A resident of Pennsylvania.
      • Uninsured and not able to receive medical assistance.
      Please call the Statewide Customer Service Center at 1-877-395-8930. For Philadelphia: 215-560-7226. for eligibility questions.

      Income guidelines

      Your household income will determine your monthly premium and copays.

      DOWNLOAD INCOME GUIDELINES 

      What do I pay?

      Once you know which CHIP - Highmark Healthy Kids plan you're eligible for, you can use the following charts to estimate your monthly premium and copays for care.

      Monthly premiums

      One Child
      Two Children
      Three or more
      Children
      Free CHIP

      $0

      $0

      $0
      Low-Cost CHIP 1

      $75.99

      $151.98

      $227.97
      Low-Cost CHIP 2

      $106.39

      $212.78

      $319.17
      Low-Cost CHIP 3

      $121.59

      $243.18

      $364.77
      Full-Cost CHIP

      $359.66

      $719.32

      $1,078.98

      *Highmark Choice Company monthly premium does not increase after three kids, regardless of how many are in your household.

      **Rates effective January 1, 2026

      Copayments for visits and prescriptions

      PCP
      Specialist
      Emergency
      Brand Name Drug
      Generic Drug
      Free CHIP

      No cost

      No cost

      No cost

      No cost

      No cost
      Low-Cost CHIP 1

      $5*

      $10

      $25*

      $9

      $6
      Low-Cost CHIP 2

      $5*

      $10

      $25*

      $9

      $6
      Low-Cost CHIP 3

      $5*

      $10

      $25*

      $9

      $6
      Full-Cost CHIP

      $15*

      $25

      $50*

      $18

      $10

      *No copay required for preventive health services on the Highmark Preventive Schedule when provided by a PCP. Preventive Schedules are available to Highmark members on their member portal. Log in to your Highmark account.

      **Emergency Room copay is waived if admitted.