CHIPs_ENGLISH_efc_7-31-22 Document Created 09/16/16 Page 2 of 2 Modi昀椀ed August 3, 2022 5:21 PM MINNESOTA – Medicaid TEXAS – Medicaid WEBSITE https://mn.gov/dhs/people-we-serve/children-and-families/health-care/ WEBSITE http://gethipptexas.com/ health-care-programs/programs-and-services/other-insurance.jsp PHONE 1-800-440-0493 PHONE 1-800-657-3739 UTAH – Medicaid and CHIP MISSOURI – Medicaid MEDICAID https://medicaid.utah.gov/ WEBSITE http://www.dss.mo.gov/mhd/participants/pages/hipp.htm WEBSITE PHONE 573-751-2005 CHIP WEBSITE http://health.utah.gov/chip MONTANA – Medicaid PHONE 1-877-543-7669 VERMONT– Medicaid WEBSITE http://dphhs.mt.gov/MontanaHealthcarePrograms/HIPP PHONE 1-800-694-3084 WEBSITE http://www.greenmountaincare.org/ EMAIL [email protected] PHONE 1-800-250-8427 NEBRASKA – Medicaid VIRGINIA – Medicaid and CHIP WEBSITE http://www.ACCESSNebraska.ne.gov https://www.coverva.org/en/famis-select WEBSITE https://www.coverva.org/en/hipp PHONE 1-855-632-7633 Lincoln: 402-473-7000 MEDICAID AND 1-800-432-5924 Omaha: 402-595-1178 CHIP PHONE NEVADA – Medicaid WASHINGTON – Medicaid WEBSITE https://www.hca.wa.gov/ MEDICAID http://dhcfp.nv.gov PHONE 1-800-562-3022 WEBSITE MEDICAID 1-800-992-0900 WEST VIRGINIA – Medicaid and CHIP PHONE NEW HAMPSHIRE – Medicaid WEBSITE http://dhhr.wv.gov/bms http://mywvhipp.com WEBSITE https://www.dhhs.nh.gov/programs-services/medicaid/health- MEDICAID 304-558-1700 insurance-premium-program PHONE PHONE 603-271-5218 CHIP 1-855-MyWVHIPP (1-855-699-8447) TOLL-FREE TOLL FREE FOR 1-800-852-3345, ext 5218 HIPP PROGRAM WISCONSIN – Medicaid and CHIP NEW JERSEY – Medicaid and CHIP WEBSITE https://www.dhs.wisconsin.gov/badgercareplus/p-10095.htm MEDICAID http://www.state.nj.us/humanservices/dmahs/clients/medicaid/ PHONE 1-800-362-3002 WEBSITE WYOMING – Medicaid MEDICAID 609-631-2392 PHONE WEBSITE https://health.wyo.gov/healthcare昀椀n/medicaid/programs-and-eligibility/ CHIP WEBSITE http://www.njfamilycare.org/index.html PHONE 1-800-251-1269 CHIP PHONE 1-800-701-0710 NEW YORK – Medicaid To see if any other states have added a premium assistance program since July 31, WEBSITE https://www.health.ny.gov/health_care/medicaid/ 2022, or for more information on special enrollment rights, contact either: PHONE 1-800-541-2831 U.S. Department of Labor U.S. Department of Health NORTH CAROLINA – Medicaid Employee Bene昀椀ts and Human Services WEBSITE https://medicaid.ncdhhs.gov/ Security Administration Centers for Medicare www.dol.gov/agencies/ebsa & Medicaid Services PHONE 919-855-4100 1-866-444-EBSA (3272) www.cms.hhs.gov NORTH DAKOTA – Medicaid 1-877-267-2323, Menu Option 4, WEBSITE http://www.nd.gov/dhs/services/medicalserv/medicaid/ Ext. 61565 PHONE 1-844-854-4825 Paperwork Reduction Act Statement OKLAHOMA – Medicaid and CHIP According to the Paperwork Reduction Act of 1995 (Pub. L. 104-13) (PRA), no persons WEBSITE http://www.insureoklahoma.org are required to respond to a collection of information unless such collection displays a PHONE 1-888-365-3742 valid Of昀椀ce of Management and Budget (OMB) control number. The Department notes OREGON – Medicaid that a Federal agency cannot conduct or sponsor a collection of information unless it is WEBSITE http://healthcare.oregon.gov/Pages/index.aspx approved by OMB under the PRA, and displays a currently valid OMB control number, http://www.oregonhealthcare.gov/index-es.html and the public is not required to respond to a collection of information unless it displays PHONE 1-800-699-9075 a currently valid OMB control number. See 44 U.S.C. 3507. Also, notwithstanding any other provisions of law, no person shall be subject to penalty for failing to comply with a PENNSYLVANIA – Medicaid collection of information if the collection of information does not display a currently valid WEBSITE https://www.dhs.pa.gov/Services/Assistance/Pages/HIPP-Program.aspx OMB control number. See 44 U.S.C. 3512. PHONE 1-800-692-7462 The public reporting burden for this collection of information is estimated to average RHODE ISLAND – Medicaid and CHIP approximately seven minutes per respondent. Interested parties are encouraged to WEBSITE http://www.eohhs.ri.gov/ send comments regarding the burden estimate or any other aspect of this collection of PHONE 1-855-697-4347, or 401-462-0311 (Direct Rite Share Line) information, including suggestions for reducing this burden, to the U.S. Department of SOUTH CAROLINA – Medicaid Labor, Employee Bene昀椀ts Security Administration, Of昀椀ce of Policy and Research, Attention: PRA Clearance Of昀椀cer, 200 Constitution Avenue, N.W., Room N-5718, Washington, DC WEBSITE https://www.scdhhs.gov 20210 or email [email protected] and reference the OMB Control Number 1210-0137. PHONE 1-888-549-0820 SOUTH DAKOTA - Medicaid OMB Control Number 1210-0137 (expires 1/31/2023) WEBSITE http://dss.sd.gov 2 of 2 PHONE 1-888-828-0059 62