Children’s Health Insurance Program Reauthorization Act of 2009 (CHIPRA)

Beginning in 2009, the Center for Medicaid and Medicare Services (CMS) has worked closely with states, other federal departments, and a broad array of private and public leaders and organizations interested in children’s health insurance coverage, to implement CHIPRA. These efforts are focused on promoting CHIPRA’s goals by continuing successful paths currently in existence as well as identifying new and innovative approaches to making health coverage a reality for all children. In 2010, the Georgia Department of Community Health (DCH) implemented the country’s first CHIPRA Premium Assistance Program.

Georgia Medicaid members may be eligible for the CHIPRA Premium Assistance Program if they are under 19 years of age or younger and have access to their or their parent’s employer group health plan and those whose employers contribute at least 40 percent towards the cost of the premium.  If approved for the CHIPRA Program, the Medicaid member must enroll or, if already enrolled, remain in the employer's health insurance plan.  CHIPRA does not pay copays, coinsurance or deductibles. Once it is determined that a Medicaid member is eligible for CHIPRA, premium payments to the employer or reimbursement to the employee will begin upon the completion of the CHIPRA application and verification process.  CHIPRA participants must continue to be Medicaid members to continue to be eligible for the CHIPRA Program.

The CHIPRA Program is advantageous to the Department and to the taxpayers. CHIPRA enables the Medicaid agency to identify liable third parties to pay for the cost of care. This ensures that Medicaid resources remain available for our most vulnerable citizens.

To determine whether you qualify for CHIPRA, contact your Medicaid worker at your local County Division of Family and Children Services (DFCS) and ask about the CHIPRA program. 

If you would like additional information about the CHIPRA program, including eligibility requirements and a CHIPRA application packet please see those documents below or contact Gainwell Technologies’ CHIPRA Unit. For further assistance with our CHIPRA program, you can reach the Georgia Department of Community Health via e-mail at [email protected].