Utah program
Child health cover just above the Medicaid line (CHIP)
Utah’s child health plan for families earning more than the Medicaid limit.
What it is
Utah’s child health plan for families earning more than the Medicaid limit.
CHIP covers children who cannot get Medicaid because of income. Other health insurance and an affordable employer offer can close this route. The employer’s premium and deductible figures matter even if nobody enrolled.
Eligibility rules
- Your child must be under 19 and live in Utah. Other enrolled health insurance generally blocks this route.
- Plan B extends to 150% of poverty and Plan C to 200%, with a separate 5% deduction rule.
- From March 1, 2026, CHIP Table I lists monthly Plan C limits for sizes 2–6: $3,607; $4,554; $5,500; $6,447; $7,394.
- For four people the CHIP line is about $5,500 a month, and the worker takes a small deduction off income before comparing. Ask for the written calculation if you are close.
What you get
- No quarterly premium for child health coverage.
- Hospital care, cancer treatment, prescriptions, dental and vision.
- Copays, deductibles and coinsurance still apply.
What the help includes
- Quarterly premiums ended October 1, 2025. The amount of other cost sharing depends on the plan.
- Dental coverage uses a separate contractor.
If you decide to apply
- Ask the hospital financial counselor to review the MyCase application with you; it checks Medicaid first.
- Have ready: this month’s household income, your child’s Social Security number, and the employer’s written premium and deductible figures.
- Ask which available plan includes your child’s oncology team.
1-866-435-7414 · Official page ↗
After you ask
- CHIP generally provides 12-month certification, subject to its continuing-eligibility rules. Existing insurance and other circumstances can change the start date.
- The notice names a plan such as Molina, SelectHealth or Healthy U. The treatment team’s participation still matters.
- CHIP usually starts on the first day of the application month, but existing coverage, a move or loss of employer insurance can change that date. Ask the counselor for the written start date and the current decision deadline before changing another plan.
Good to know
An employer offer can block CHIP even without enrollment. The worker checks the premium, deductible, income deduction and enrollment rules.
Other details
- State CHIP is a separate immigration-related route that closed to new enrollment January 31, 2026. Existing members may continue while they remain eligible and complete required reviews; existing membership is not an unconditional guarantee of continued coverage.
- If your employer offers a plan that would cost less than about 5% of your income to cover your child (the premium plus a twelfth of the deductible), CHIP is closed even if you never signed up. Bring the employer's rate sheet so the worker can check. (one bullet)
Federal background: Children’s Health Insurance Program.
Official sources
- CHIP Policy Manual, Table I — Income Limits
- CHIP policy 602, Cost Sharing Requirements
- CHIP policy 220-4, Access to Employer-Sponsored Health Insurance
- CHIP policy 220-2, Coverage Under a Health Insurance Plan
- CHIP policy 220-6, Coverage or Access to Coverage Under a State Employees Group Health Plan
- CHIP policy 701-3, Effective Dates of Certification
- CHIP policy 703-1, Length of the Certification Period
- Utah Medicaid Managed Care
- State CHIP enrollment notice
- Medicaid Policy Manual, Table VII — Income Limits for Medical and Medicare Cost-Sharing Programs
- Medicaid Policy Manual, Table IX — Telephone Numbers
- Official source reviewed September 21, 2026
- Official source reviewed September 21, 2026
- Official source reviewed September 21, 2026
“Could CHIP cover our child, or would our employer’s offer prevent it? What costs would remain, and could you help us compare the plans before deciding?”
Why I’m asking: I want an affordable plan that includes the cancer team, without creating a gap in coverage.
More background and detailed requirements
Additional program information and published rules
Who does what
The three parts, side by side. The agency decides; nobody on this page does.
You
Apply on MyCase and get the employer's premium and deductible figures in writing.
Your social worker
The hospital financial counsellor helps with the application and checks the oncology team is in the plan you pick.
The care team
Records and letters when the application asks for them.
- Who decides
- Department of Workforce Services eligibility staff decide; Molina, SelectHealth or Healthy U runs the cover.
- Ask HR
- “Can you give me in writing the monthly premium and the deductible for family cover, so the state can run its affordability test?”
How to apply
First step: Apply on MyCase at jobs.utah.gov/mycase, or call 1-866-435-7414.
- Apply on MyCase; the one application checks Medicaid first and CHIP after.
- Ask your employer's HR for the premium and the deductible in writing, so the office can run the affordability test.
- If a bill has already landed, say so: a four-day medical-need grace can pull cover back into last month.
Official application / program page ↗
Where it starts: Apply on MyCase or call 1-866-435-7414. The same application looks at Medicaid first.
What to gather
- This month's income for the tax household
- The employer's written premium and deductible for family cover
- Your child's Social Security number
How long: Utah did not publish a decision clock for CHIP. Cover normally starts on day one of the month you apply.
What a yes looks like
A notice naming Molina, SelectHealth or Healthy U, and a 12-month certification. Check the oncology team is in that plan.
What a no looks like, and the next move
If the no is about an employer offer, ask for the affordability figures the office used and check them against your pay slip.
Watch out
- An affordable employer offer closes CHIP even if nobody enrolled. Get the premium and deductible in writing before you apply.
- State CHIP closed to new enrollment January 31, 2026. Existing members may continue while eligible and completing required reviews.
- Utah's Medicaid table and its CHIP table disagree by fifty dollars at a household of four; ask the worker which one they are using.
The numbers and the rules
The arcane layer, kept on purpose. Checked September 11, 2026.
What it is worth
Full child cover with no quarterly premium. For four people the top line is $5,500 a month; copayments and deductibles remain.
- $5,500/month — Plan C top line (200%), household of 4
- $4,125/month — Plan B line (150%), household of 4
- $7,394/month — Plan C top line (200%), household of 6
- $0 — Quarterly premium
Covers: Doctor, hospital and specialist care · Chemotherapy and prescriptions · Dental through a separate contractor · Vision
What it costs the family: No quarterly premium from October 1, 2025. Copayments, deductibles and coinsurance still apply.
The eligibility facts, as published
- Age
- under 19
- Age max exclusive
- 19
- Income
- Plan B to 150% and Plan C to 200% of the poverty line; a 5% deduction rule sits behind them
- Insurance status condition
- no other enrolled health insurance, and no affordable employer offer
- Residency
- Utah
- Continuous eligibility
- 12 months
- Processing standard
- unknown
- Note
- Medicaid Table VII prints $5,550 for a household of four where CHIP Table I prints $5,500; the program's own table is used, and the lower figure is the cautious one.
Decisions this site cannot make: Department of Workforce Services eligibility decision · Employer-offer affordability test
Expect friction on: An affordable employer offer bars enrolment even if nobody took it up · Only three health plans statewide
The trap: The bar is about the offer, not just the enrolment. Utah tests whether the premium plus the monthly deductible comes to less than 5% of countable income; under that, the offer is affordable and CHIP is closed. School-district workers are not counted as state employees for the separate state-plan bar.
Where I read this
- CHIP Policy Manual, Table I — Income Limits — Utah Department of Health and Human Services, read September 10, 2026
- CHIP policy 602, Cost Sharing Requirements — Utah Department of Health and Human Services, read September 10, 2026
- CHIP policy 220-4, Access to Employer-Sponsored Health Insurance — Utah Department of Health and Human Services, read September 10, 2026
- CHIP policy 220-2, Coverage Under a Health Insurance Plan — Utah Department of Health and Human Services, read September 10, 2026
- CHIP policy 220-6, Coverage or Access to Coverage Under a State Employees Group Health Plan — Utah Department of Health and Human Services, read September 10, 2026
- CHIP policy 701-3, Effective Dates of Certification — Utah Department of Health and Human Services, read September 10, 2026
- CHIP policy 703-1, Length of the Certification Period — Utah Department of Health and Human Services, read September 10, 2026
- Utah Medicaid Managed Care — Utah Department of Health and Human Services, read September 10, 2026
- State CHIP enrollment notice — Utah Department of Health and Human Services, read September 10, 2026
- Medicaid Policy Manual, Table VII — Income Limits for Medical and Medicare Cost-Sharing Programs — Utah Department of Health and Human Services, read September 10, 2026
- Medicaid Policy Manual, Table IX — Telephone Numbers — Utah Department of Health and Human Services, read September 10, 2026