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

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

Notice issued by the U.S. Department of Labor U.S. Department of Health and Human Services

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 22, 2010. You should contact your state for further information on eligibility –

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ALABAMA –Medicaid	CALIFORNIA – Medicaid
Website Phone: 1-800-362-1504	Website Phone: 1-800-635-2570
ALASKA – Medicaid	COLORADO – Medicaid and CHIP
Website Phone: 1-888-318-8890 Phone (Anchorage): 907-269-6529	Medicaid Website Medicaid Phone: 1-800-866-3513 CHIP Website CHIP Phone: 303-866-3243
ARIZONA – CHIP	FLORIDA – Medicaid
Website Phone: 602-417-5422	Website Phone: 1-866-762-2237
ARKANSAS – CHIP	MONTANA – Medicaid
Website Phone: 1-888-474-8275	Website Telephone: 1-800-694-3084
GEORGIA – Medicaid	NEBRASKA – Medicaid
Website Phone: 1-800-869-1150	Website Phone: 1-877-255-3092
IDAHO – Medicaid and CHIP	NEVADA – Medicaid and CHIP
Medicaid Website Medicaid Phone: 208-334-5747 CHIP Website CHIP Phone: 1-800-926-2588	Medicaid Website Medicaid Phone: 1-800-992-0900 CHIP Website CHIP Phone: 1-877-543-7669
INDIANA – Medicaid	NEW HAMPSHIRE – Medicaid
Website Phone: 1-877-438-4479	Website Phone: 1-800-852-3345 x 5254
IOWA – Medicaid	NEW JERSEY – Medicaid and CHIP
Website Phone: 1-888-346-9562	Medicaid Website Medicaid Phone: 1-800-356-1561 CHIP Website CHIP Phone: 1-800-701-0710
KANSAS – Medicaid	NEW MEXICO – Medicaid and CHIP
Website Phone: 1-800-635-2570	Medicaid Website Medicaid Phone: 1-888-997-2583 CHIP Website CHIP Phone: 1-888-997-2583
KENTUCKY – Medicaid	NEW YORK – Medicaid
Website Phone: 1-800-635-2570	Website Phone: 1-800-541-2831
LOUISIANA – Medicaid	NORTH CAROLINA – Medicaid
Website Phone: 1-888-342-0555	Website Phone: 919-855-4100
MAINE – Medicaid	SOUTH CAROLINA – Medicaid
Website Phone: 1-800-321-5557	Website Phone: 1-888-549-0820
MASSACHUSETTS – Medicaid and CHIP	TEXAS – Medicaid
Medicaid & CHIP Website Medicaid & CHIP Phone: 1-800-462-1120	Website Phone: 1-800-440-0493
MINNESOTA – Medicaid	UTAH – Medicaid
Website Phone: 800-657-3739	Website Phone: 1-866-435-7414
MISSOURI – Medicaid	VERMONT– Medicaid
Website Phone: 573-751-6944	Website Telephone: 1-800-250-8427
NORTH DAKOTA – Medicaid	VIRGINIA – Medicaid and CHIP
Website Phone: 1-800-755-2604	Medicaid Website Medicaid Phone: 1-800-432-5924 CHIP Website CHIP Phone: 1-866-873-2647
OKLAHOMA – Medicaid	WASHINGTON – Medicaid
Website Phone: 1-888-365-3742	Website Phone: 1-800-562-6136
OREGON – Medicaid and CHIP	WEST VIRGINIA – Medicaid
Medicaid Website Medicaid Phone: 1-800-359-9517 CHIP Website CHIP Phone: 1-800-359-9517	Website Phone: 304-342-1604
PENNSYLVANIA – Medicaid	WISCONSIN – Medicaid
Website Phone: 1-800-644-7730	Website Phone: 1-800-362-3002
RHODE ISLAND – Medicaid	WYOMING – Medicaid
Website Phone: 401-462-5300	Website Telephone: 307-777-7531

To see if any more states have added a premium assistance program since January 22, 2010, 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 07/31/2010)

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

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

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