Important Regulations
Premium Assistance under Medicaid and Children’s Health Insurance Program (CHIP)
Plan Features
Everything You’ll Need to Know
Premium Assistance Under Medicaid and the Children’s Health Insurance Program (CHIP)
If you or your children are eligible for Medicaid or CHIP and you’re eligible for health coverage from your employer, your state may have a premium assistance program that can help pay for coverage using funds from their Medicaid or CHIP programs.
If you or your children aren’t eligible for Medicaid or CHIP, you won’t be eligible for these premium assistance programs. Still, you may be able to buy individual insurance coverage through the Health Insurance Marketplace. For more information, visit www.healthcare.gov. If you or your dependents are already enrolled in Medicaid or CHIP and you live in the State listed below, 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, 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, ask your state if it has a program that might help you pay the premiums for an employer-sponsored plan.
If you or your dependents are eligible for premium assistance under Medicaid or CHIP, as well as eligible under your employer plan, your employer must allow you to enroll in your employer plan if you aren’t already enrolled. This is called a “special enrollment” opportunity, and you must request coverage within 60 days of being determined eligible for premium assistance. If you have questions about enrolling in your employer plan, contact the Department of Labor at www.askebsa.dol.gov or call 1-866-444-EBSA (3272).
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 31, 2022. Contact your State for more information on eligibility –
Pennsylvania – Medicaid |
Phone: 1-800-692-7462 |
Contact Information |
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Benefit | Provider | Web Site | Phone Number |
Medical & Vision | Independence Blue Cross & Davis Vision | www.ibx.com | Call the number on the back of your ID Card or1-800-275-2583 |
Prescription Drug Coverage | Capital Rx | www.cap-rx.com | 1-888-832-2779 |
Dental | MetLife | www.metlife.com/mybenefits | 1-800-438-6388 |
Flexible Spending Accounts | C-BIZ – FLEX | WWW.MYPLANS.CBIZ.COM | 1-800-815-3023 OPTION 4 |
Employee Assistance Program | ComPsych Guidance Resources through One America | Guidanceresources.com (Web ID: ONEAMERICA3) | 1-855-387-9727 |
Employee Insurance Assistance | Health Advocate | www.HealthAdvocate.com | 1-866-695-8622 |
Retirement Plan | PSERS | https://www.psers.pa.gov/ | Toll-Free Number: 1.888.773.7748 |
Plan Documents
Websites
Contacts
Department of Labor
1-866-444-3272
State Medicaid or CHIP
1-877-KIDS NOW
Pennsylvania – Medicaid
1-800-692-7462