North Carolina Health Choice for Children (CHIP)

Information from Benefits.gov and the North Carolina Department of Health and Human Services

Description: The North Carolina Health Choice (NCHC) Health Insurance Program for Children is a comprehensive health coverage program for low-income children. The goal of the NCHC Program is to reduce the number of uninsured children in the State. If your family makes too much money to qualify for Medicaid, but too little to afford private or employer-sponsored health insurance, your child (ren) may qualify for NCHC.

Eligibility:

1. Children must:
-Be between the ages of 6 through 18;
-Be ineligible for Medicaid, Medicare, or other federal government-sponsored health insurance;
-Be uninsured;
-Be in a family whose family income is above one hundred percent (100%) through two hundred percent (200%) of the federal poverty level;
-Be a resident of this State and eligible under federal law; and,
-Have paid the Program enrollment fee required under this part.
-Proof of family income and residency and declaration of uninsured status shall be provided by the applicant at the time of application for Program coverage. The family member who is legally responsible for the children enrolled in the Program has a duty to report any change in the enrollee’s status within 60 days of the change of status.

2. If a responsible parent is under a court order to provide or maintain health insurance for a child and has failed to comply with the court order, then the child is deemed uninsured for purposes of determining eligibility for Program benefits if at the time of application the custodial parent shows proof of agreement to notify and cooperate with the child support enforcement agency in enforcing the order.If health insurance other than under the Program is provided to the child after enrollment and prior to the expiration of the eligibility period for which the child is enrolled in the Program, then the child is deemed to be insured and ineligible for continued coverage under the Program. The custodial parent has a duty to notify the Department within 10 days of receipt of the other health insurance, and the Department, upon receipt of notice, shall disenroll the child from the Program. As used in this paragraph, the term “responsible parent” means a person who is under a court order to pay child support.

3. Except as otherwise provided in this section, enrollment shall be continuous for one year. At the end of each year, applicants may reapply for Program benefits.

How to Apply for Health Choice for Children: N.C. Health Choice is available only to those children who do not qualify for Medicaid. There is not a separate application for Health Choice. All children who are not eligible for Medicaid are evaluated for Health Choice.

Applying Online

You may apply for Medicaid and NC Health Choice or CHIP online via NC ePASS.

Applying in Person

You may apply at the County Department of Social Services (DSS) in the county where you live.

If possible, take the items listed below with you when you go to the DSS office to apply. If you do not have some or all of these items, please apply anyway because it is very important to protect your application date. The DSS can assist you in obtaining these items and information.

  • Certified birth certificates or other proof of citizenship/alien status for each individual applying for Medicaid/NCHC
  • Identity documents for each individual applying for Medicaid/NCHC
  • Social security cards, social security numbers, or proof that you have made an application for a number from the Social Security Office, for each individual applying for Medicaid or NCHC
  • A copy of all pay stubs for last month
  • Copies of all medical or life insurance policies
  • A list of all cars, trucks, motorcycles, boats, etc. you or anyone in your household own, including the year, make, model, and vehicle identification number (VIN) for each item
  • Most recent bank statements
  • A list of all real property you own
  • Current financial statements/award letters from other sources of income, such as social security, retirement benefits, pensions, veteran benefits, and child support.

You are not required to bring an application with you, but it may speed the process to print and fill out as much of the application as you can ahead of time.

If You are Unable to Apply in Person

If you are unable to go to a DSS office, you may also print and mail completed Medicaid and Health Choice Applications to your local DSS office. Or you may call and ask that an application form be mailed to you. If you are disabled, a county representative may be able to make a home visit to assist you with the application process.

Faxed applications and applications received over the internet are not acceptable.

Some health centers and hospitals have application forms available and may be able to assist you in completing them.