A child who enrolls in CHIP for the first time after being covered by private health insurance can expect to have a 90-day waiting period before CHIP coverage begins.
There are exceptions:
The 90-day waiting period does not apply to children who lost insurance coverage because:
- Their parents separated, divorced, or got remarried.
- A parent died.
- A parent lost the family's health insurance they had through work.
- A parent's COBRA benefits ended
- The Texas Employees Retirement System no longer covers the child.
- A parent's employer stopped offering dependent health coverage
The 90-day waiting period also does not apply to the following children:
- A child who has special health care needs.
- A child who lost CHIP coverage in another state.
- A child who lost coverage in Medicaid, CHIP, or any health insurance affordability program. This includes health insurance plans found on the Healthcare.gov website offering premium tax credits and cost-sharing reductions.
- A child whose health insurance premium costs more than 5 percent of the family's gross income.
- A child whos family health insurance premium that includes the child is more than 9.5 percent of the family's income.
In addition, HHSC can waive the 90-day waiting period if the agency determines a good cause exists based on facts in the application or information HHSC gets from other sources.