FirstCare CHIP Plans
CHIP
The Children’s Health Insurance Program (CHIP) is a health plan for children 18 years 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 Chart.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:
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
CHIP Perinatal (Mother) Benefits:
- One visit every four weeks for the first 28 weeks of pregnancy
- One visit every two to three weeks from 28 to 36 weeks of pregnancy
- One visit per week from 36 weeks to delivery. (Limited to 20 prenatal visits)
- 2 postpartum visits
- Pharmacy, limited lab tests, planning services, and education and counseling
- For women that qualify, inpatient services related to labor with delivery
- Preterm labor that does not result in a birth and false labor are not covered benefits
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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, click here.
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.
What Service Coordination Can Help With
The nurses and social workers are here to help you:
- Get care, services, equipment and medications.
- Understand and manage your health conditions.
- Tunderstand and get the most out of your benefits.
- Understand the healthcare system and get needed authorizations and referrals.
- Find programs and community resources for things your insurance does not cover.
What to Expect
After being referred to Service Coordination, one of our team members will call you and complete an assessment over the phone. You can expect this call within four (4) days. This assessment will help us identify what needs you have. We will work with you to create a plan of how to meet your needs. We will work with you on your plan until your needs are met, you no longer have coverage with us, we can no longer reach you or you decide you no longer want help.
You will be linked with a nurse or social worker who you can call directly anytime you need help. Your nurse or social worker can also work with your doctor or pharmacy to help you. Health information is confidential and protected. Having Service Coordination does not affect your plan coverage.
How to Request Service Coordination to Help You:
To request Service Coordination, call: 1-877-639-2447 and ask to speak with a member of our team. You can also email us to request Service Coordination at: CaseMgmt@BSWHealth.org.
Our Case Managers are available between 8 AM and 5 PM CT weekdays (except for state-approved holidays). TTY users can call 711.
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Grow WellTM
findhelp
Find Free or Reduced Cost Local Resources
What can findhelp do?
Find free or reduced cost local resources to help with:
- Child care assistance
- Food
- Rent
- Social Services
- And more
How can I access findhelp?
You can access findhelp via the member portal under Wellness & Community and Connect to Local Resources. You can also access at
bswhealthplan.findhelp.com.
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Papa Pals
Extra Support for New Moms
Who qualifies?
Papa Pals is for active FirstCare CHIP members from birth to one year of age and pregnant CHIP members. You can receive up to 120 hours of service per year.
How can Papa Pals help?
Papa Pals can help new parents with:
- Social support
- Home visits
- Child care assistance
- Meal preparation
- Laundry and light cleaning
- Grocery and prescription delivery
- Short-distance travel for errands and appointments
- And more
How can I get Papa Pals?
- You may receive a phone call from Papa Pals. They can sign you up during the phone call.
- You can call Papa Pals to sign up. Phone number: 888.345.2619; TTY users, please call 711. Business hours are 7 AM – 10 PM from Monday – Friday and 7 AM – 7 PM on Saturday and Sunday. (Tell them you are a member of FirstCare Health Plans.)
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