Utah CHIP Benefits at a Glance

For benefit details including co-pay amounts (the portion of the cost you pay for some services), please read your Member Handbook or call Member Services at (888) 483-0760. 

List of Covered Services List of Non-Covered Services
Abortions and sterilizations (if criteria is met, with required forms) Abortions, except to save mother’s life or result of rape or incest, with required forms
Ambulance, ground and air for medical emergencies Acupressure
Applied Behavior Analysis (ABA) for the treatment of Autism Spectrum Disorder (ASD)  ADHD  
Approved clinical trials Allergy tests and treatment, selected types
Diabetes, to help educate Dialysis for end stage renal disease Anesthesia, general, while in doctor’s office
Doctor visits, including specialists Biofeedback
Drugs prescribed by your doctor Birthing centers and home childbirth
Eye exams Cancer therapy, neutron beam
Emergency care, seven days a week, 24 hours a day Certain drugs and medicines (such as weight loss drugs, non-FDA drugs, etc.)
Family planning Certain immunizations (anthrax, BCG, plague, typhoid yellow fever, and others)
Having a baby, including high-risk services Certain pain services
Hearing exams Charges/services not for medical purposes
Home health Chiropractic services
Hospice (end-of-life care) Claims after one year
Hospital services, inpatient and outpatient Conditions caused by crime
Immunizations Dental anesthesia unless criteria is met
Labs and X-rays Device to correct or support the foot 
Treatment for miscarriage (losing your baby due to natural causes) Dry needling
Medical equipment and supplies Experimental services
Mental health services Eye surgery for vision (such as LASIK)
Occupational therapy Family planning (specifically Norplant, infertility drugs, in-vitro fertilization, genetic counseling)
Organ transplants (bone marrow, heart and lung, pancreas and kidney, cornea, heart, kidney, liver, lung) Fitness training, exercise equipment, fees for gym, etc.
Physical therapy Food-based treatment


Gene therapy


Genetic counseling

Prior Authorization

Some services must be approved before they will be paid. Permission to receive payment for that service is called Prior Authorization. Prior Authorization is needed for:

  • Hospital/outpatient stay (non-emergency)
  • Surgery
  • Some office procedures
  • Some x-rays and lab tests
  • Home health care
  • Medical equipment and supplies
  • Long term care (nursing home or rehab)
  • Physical, occupational, and speech therapy (Approval is needed after 12 combined visits per calendar year)


Updated April 30, 2024