Children’s Health Insurance Program

While Medicaid insures many children in West Virginia, some children are also eligible to participate in the Children’s Health Insurance Program, more commonly known as CHIP.  Medicaid is intended to provide health benefits to the poorest children in the state. CHIP expands health insurance coverage to children in families who have incomes above the Medicaid eligibility threshold who do not have commercial insurance. Services provided through CHIP are generally comparable to those offered under the Medicaid program, however the breadth of coverage for CHIP services is determined by each state.

CHIP works with managed care organizations (MCO). MCOs are health care providers or a group of medical service providers contracted with insurers and self-insured employers to provide a wide variety of managed health care services to enrolled workers through participating providers. Each MCO has different tiers, which determine copayment amounts. Contact your CHIP provider to determine copayment amounts for covered services. 

Provider Visits

One physician’s office visit a year for a preventive check-up is covered for all insured children ages 2 through 18. Infants under age 2 are covered for more frequent checkups as recommended by the AAP guideline.

Preventive Services

  • Immunizations
  • Nutritional education
  • Vision services (annual exams & eyewear)
  • Well-baby & well-child exams – Children should have routine well checks according to the guidelines set forth by the American Academy of Pediatrics. In addition, West Virginia children are expected to have a well-child or HealthCheck exam before entering public preschool classes or kindergarten. Age-appropriate immunizations as indicated by your medical provider
    • Blood pressure checks
    • Developmental/behavioral assessment
    • Hearing Screening
    • Height and weight measurement
    • Lead risk screening
    • Objective vision and hearing screening BMI calculation
    • Physical exams