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Health care benefit programs issued or administered by Capital BlueCross and/or its subsidiaries, Capital Advantage Insurance Company^®, Capital Advantage Assurance Company^® and Keystone Health Plan^® Central. Independent licensees of the BlueCross BlueShield Association serving 21 counties in Central Pennsylvania and the Lehigh Valley. Communications issued by Capital BlueCross in its capacity as administrator of programs and provider relations for all companies.

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Free CHIP application help for your family

Get help with your CHIP application today

The Children's Health Insurance Program (CHIP) ensures your kids get the health coverage they need. We're here to ensure the CHIP application process is simple and hassle-free for you.

Make sure the details are covered.

We'll walk you through your application and make sure all necessary information is included. Our goal is to simplify the experience for you.

Sign up and we'll be in touch.

Please complete the form below, and we'll call you back to offer personalized assistance with your CHIP application.

Required fields are noted with an asterisk*.

* First name

* Last name

* Child's first name

* Child's last name

* Child's date of birth

* Email

* Phone number

* Date to call

* Best time to call

By providing my phone number and/or email address, I give my permission for a Capital Blue Cross Health Plan-appointed sales representative to contact me, answer my questions, and discuss my options. I also agree that Capital Blue Cross Health Plan, its affiliates, subsidiaries, and/or agents may communicate with me by phone, text, or email for transactional, informational, or marketing purposes, including calls and messages made using an automatic telephone dialing system or pre-recorded voice messages. I understand my consent is not a condition of purchasing any goods or services.

By clicking on "Submit", I agree that Capital Blue Cross, its affiliates, subsidiaries, agents, and/or InsureMe, Inc may communicate with me by phone, text, or email...

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Get help with your CHIP application today

Make sure the details are covered.

Sign up and we'll be in touch.

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Thank You!

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