Certified Application Counselor Practice Test

If kids are eligible for CHIP, are they also eligible for APTC or CSRs in the marketplace?

1. Yes, they must enroll

2. No, they are not eligible

3. Only if the household income is below 200 percent FPL

4. Yes, but only for limited coverage

The correct answer is: No, they are not eligible

Children who qualify for the Children's Health Insurance Program (CHIP) are not eligible for Advanced Premium Tax Credits (APTC) or Cost-Sharing Reductions (CSRs) in the health insurance marketplace. CHIP provides comprehensive coverage for children from families with incomes that are too high to qualify for Medicaid but too low to afford private coverage. The reason for this is that CHIP is designed to be more affordable and accessible for children, providing them with tailored benefits that meet their needs. Families can choose to enroll in CHIP for their children, receiving redacted costs for their coverage through this program. When families enroll their children in CHIP, they access benefits specifically tailored for pediatric care without the additional financial assistance that comes with APTC or CSRs, which are intended for different marketplace plans. In essence, since CHIP is available to eligible children, those enrolled will not receive additional financial assistance from the marketplace, which includes APTC or CSRs, reinforcing CHIP's role as an alternative safety net for children's healthcare coverage.