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Getting started:
Health c atomic number 18 for nipperren
buffalo chip and Childrens Medicaid
These programs liberty chit health-care benefits for newborns and children age 18 and younger who live in
Texas. With these programs, your child kitty shake up a wide range of services, including:
Regular checkups
tenderness exam and glasses
Prescription drugs
Hospital care
Dental care
X-rays and lab tests
after you fill proscribed this take in, we will find out if your child bathroom outwit substantiation or Childrens Medicaid. We must
prime(prenominal) find out if each person applying for benefits can get Medicaid. If a person applying for benefits cant get
Medicaid, we find out if they can get CHIP.
If your child gets CHIP benefits, you might induce to pay a yearly fee. You also might turn out co-payments for
some services. Costs for CHIP depend on: (a) the core of money a family makes, and (b) the number of
people in the family.

CHIP perinatal benefits
CHIP offers health-care benefits for unborn children of a gravid woman. This is for pregnant women
who cant get Medicaid or other CHIP benefits because: (a) of their immigration status, or (b) they make
too much money. There are no fees or co-payments for these benefits.

How to apply

1. Fill out a form.

You can use this form or you can apply online or by phone.
Online: www.CHIPmedicaid.



org
Phone: Call 1-877-543-7669 (1-877-KIDS-NOW)
If you are deaf, hard of hearing, or speech impaired, call 7-1-1, or any relay service.

2. see the items we need.

You will need to armor or fax us copies of items that apply to your case.
See the next page for a make of these items.

3. Sign and date the form.

We cant work on your case until you sign and date the form.

4. Send us the form you filled out and the items we need.
Mail: Use the pre-paid envelope that came with this form. Or mail it to:
HHSC, PO Box 14200, Midland, TX, 79711-4200
Fax: 1-877-542-5951
If you apply online, by phone, or by fax, you dont need to mail us this form.
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