CHIP Application Instructions

There are several ways to apply for CHIP:

Paper Application/Download

Fill out all the required fields in the application form which you can find here:

Once complete mail it to:

Mississippi CHIP
239 North Lamar Street, Suite 801
Jackson, MS 39201-1399

You can also submit it to a local, authorized Human Services Office. For a complete list of Human Services Offices, click here:

Apply by Phone/In-Person

You may also call 1 (800) 421-2408 and request that an application form be sent to you. Once you have completed it, submit it to the local Human Services Office where a local representative will assist and interview you.

You can locate you local office here:

Or, call us, Monday to Friday, 7 a.m. to 7 p.m. at 1 (800) 257-8563 (voice) or TDD: 515-457-8051/1 (888) 422-2319

In order to get more information or request for an application form to be sent to you, you can call the toll free number above. This is very helpful as one is able to talk to a professional who will guide him or her through the application process.

Eligibility Requirements

The Children's Health Insurance Program, also known as CHIP provides quality, no to low cost medical services to children and certain adults whose households have incomes below the poverty level. You can apply for CHIP if you are:

  • 19 years old and below who do not have any kind of insurance
  • Pregnant women
  • Legal alien
  • Low income parents/guardians with children under 18
  • Working person with disability with child dependents not more than 18 years old

To check if you are eligible for CHIP, consult the Eligibility Guidelines which can be found here: