Pennsylvania expands CHIP coverage so families avoid penalties
Under the new rules, CHIP plans are barred from setting dollar limits on essential health benefits
Image of Gov. Tom Wolf from Wikipedia.
Pennsylvania families that faced penalties for Children's Health Insurance Program coverage that did not meet minimum requirements set by the Affordable Care Act are in the clear after Gov. Tom Wolf on Thursday said the state expanded its CHIP program.
"Currently, only CHIP policies where the families pay the entire cost of the premiums must meet these enhanced benefit requirements," Wolf said in a statement. "However, I believe it is important that all Pennsylvania children have access to the best healthcare possible, and so I am implementing this requirement to provide enhanced benefits for all 148,000 Pennsylvania children covered by CHIP."
Under the new rules, CHIP plans are barred from setting dollar limits on essential health benefits. Those include hearing aids, pediatric vision, dental and orthodontic services and durable medical equipment. Previously, the Pennsylvania plan set $1,500 annual limits for orthodontics and $5,000 annual limits for medical equipment.
The change also means services such as plaque control programs, oral hygiene education, dietary instruction and prescribed iron supplements will be given without cost-sharing, which includes co-payments and deductibles.
Wolf in 2014 secured federal waivers for the 3,600 families paying full-cost coverage, generally higher-income families, to give the state time get its benefits in line with federal standards before the Dec. 1 deadline.
The CHIP program insures children under 19 who qualify for the subsidized insurance. Families under a certain income bracket pay nothing for the coverage.
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