FirstCare CHIP Plans

CHIP

The Children’s Health Insurance Program (CHIP) is a health plan for children 18 years old and younger. CHIP is for families when their income is too high for Medicaid but they can't afford other insurance. CHIP covers health services like checkups, lab tests, x-rays, hospital stays, medicines, dental care and more.

CHIP Perinatal

CHIP Perinatal benefits are services to the unborn child of a pregnant woman who does not qualify for other Medicaid programs or traditional CHIP. The program will also continue services for some newborn children after delivery. To learn more about the program and other benefits for pregnant women, visit our Healthy Pregnancy page.

CHIP Perinatal Newborn

Chip Perinatal Newborn coverage begins the day the child is born. Your baby will receive the CHIP Perinatal Newborn benefits. Coverage will end at the end of the 12 months of coverage from the month eligibility was determined.

Is there a cost to join CHIP?

There may be a cost to join FirstCare CHIP. The cost is based on the family income, assets and size. The cost may have an enrollment fee and co-payments. Most co-payments for doctor visits and medicines drugs are from $3 to $20 for lower-income families and $20 to $35 for higher-income families.

Enrollment fees are $50 or less per family, per year. For more info, see the CHIP Yearly Enrollment Fees.There is no cost to join the CHIP Perinatal program and no cost for care.

For more information on cost-sharing, see the CHIP Cost-Sharing Table.

How to Choose a Primary Care Provider

Your Primary Care Provider (PCP) must be a FirstCare CHIP provider. To find a participating provider, you can do one of the following:

• Search our Online Provider Directory.
• Search the FirstCare CHIP Provider Directory.
• Call FirstCare CHIP Customer Service at 1-877-639-2447.

When you fill out your Enrollment Form, list the PCP you have chosen. There is a space on the form for the name and provider number. Your PCP will be the doctor in charge of your health care. Visiting the same doctor for checkups and when you are sick can help your doctor keep an eye on your health. You can go to a family planning, OB/GYN, behavioral health, and/or other health care provider. You do not need a referral by a PCP.

How does CHIP work?

CHIP Members - When you join CHIP, you will pick a doctor (PCP) for your child. Your child will be sent a CHIP ID card. The PCP you choose will be listed on your child's ID card. You will need to show your child's CHIP ID card at each doctor visit.

CHIP Perinatal Members - When you are a pregnant mother of an unborn child, you will pick a doctor (PCP) for care while you are pregnant. You will be sent a CHIP Perinatal ID card to use before your baby is born. You will need to show your CHIP Perinatal ID card at each doctor visit.

CHIP Perinatal Newborn Members - Once your baby is born, you will pick a doctor (PCP) for your baby. Your baby will be sent a CHIP Perinatal ID card. The PCP you choose will be listed on your baby’s ID card. You will need to show your baby’s CHIP Perinatal Newborn ID card at each doctor visit.

What are the benefits of FirstCare CHIP?

CHIP and CHIP Perinatal Newborn Benefits:

• No limit on RX
• Hospital care as long as medically needed
• Doctor Visits

How do I access covered services?
What should I do if I have an emergency?

To access covered services, call FirstCare CHIP or CHIP Perinatal Customer Service at 1-877-639-2447. If you are having an emergency and need immediate medical care, go to the nearest Emergency Room (ER) or call 9-1-1. If you do not have life threatening injuries or symptoms or do not need immediate medical care, call your PCP first. Your doctor can help you and give you advice.

How do I replace my ID card if it is lost or stolen?

If you need to replace your ID cards, call FirstCare Customer Service tollfree at 1-877-639-2447 and we can assist you.

Member Portal

FirstCare members have access to our online Member Portal. Here, you can look up your claims, view your benefits and find important plan documents. To log in/register, visit my.firstcare.com/web.

Keep your benefits!

CHIP enrollment will need to be renewed every 12 months. If you have questions, call FirstCare at 1-866-787-0663.

FirstCare's Disease Management Program

The disease management program provides specialized help from registered nurses for members with conditions such as: Asthma, Diabetes and Musculoskeletal Conditions (injuries or disorders of the muscles, nerves, tendons, joints, cartilage and spinal discs).

The program offers education and coordination of care between your doctors and benefits. You can talk and work with a nurse who has been certified and licensed by the state. We want to help you get information and the support you need. Please call us at 1-855-828-1013 if you would like the extra help. Our disease management programs are at no additional cost to you.

Service Coordination Program

All Health Plan members with current coverage can have Service Coordination. The program is an added benefit for our members. Service Coordination is at no cost to the member. Our program is completely voluntary so members may opt in or out at any time.

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