Medicaid and the Children’s Health Insurance Program (CHIP)

Free or low-cost health coverage for children and families

If you or your children are eligible for Medicaid or the Children’s Health Insurance Program (CHIP) and you are also eligible for employer sponsored health coverage through a plan such as the Professional Musicians, Local 47 & Employers’ Health & Welfare Fund, you may be eligible for premium assistance programs that are provided by some states.

These states — which do not include California — use funds from their Medicaid or CHIP programs to provide this assistance.

If you or your children are not eligible for Medicaid or CHIP, you will not be eligible for these premium assistance programs, but you may be able to buy individual insurance coverage through a Health Insurance Marketplace. For more information, visit www.healthcare.gov.

If you or your dependents are already enrolled in Medicaid or CHIP, you can 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, you can contact your state Medicaid or CHIP office. Dial (877) KIDS-NOW or visit www.insurekidsnow.gov to learn how to apply. If you qualify, you can ask the state if it has a program that might help you pay the premiums for an employer-sponsored plan.

Once it is determined that you or your dependents are eligible for premium assistance under Medicaid or CHIP and are also eligible under your employer-sponsored plan, your employer must permit you and your dependents to enroll in your employer-sponsored plan if you are eligible. This is called a “special enrollment” opportunity. You must request coverage within 60 days of being determined eligible for premium assistance.

If you have questions about which states have premium assistance programs or require information on special enrollment rights, contact the U.S. Department of Labor at askebsa.dol.gov or call (866) 444- EBSA (3272). You can also contact the U.S. Department of Health and Human Services Centers for Medicare & Medicaid Services at cms.hhs.gov or (877) 267-2323, ext. 61565.