CHIP, the Children's Health Insurance Program, provides low-cost health coverage for children up to age 19 in families that earn too much for Medicaid but cannot afford private insurance. Apply through your state Medicaid/CHIP agency, InsureKidsNow.gov, or HealthCare.gov any time of year - one application checks your children for both Medicaid and CHIP. Some states also cover pregnant people through CHIP.
How it works
The short version, before the detail.
CHIP was created to cover children in families caught in the gap: earning too much for Medicaid but not enough to afford private coverage. It is jointly funded by the federal government and states. Some states run CHIP as an expansion of Medicaid, some as a separate programme with its own name, and some as a combination.
Income limits for children are considerably higher than for adults in most states. A family where the parents would not qualify for Medicaid themselves may find their children qualify for Medicaid or CHIP. This is why advocates say: always apply for the children, even if you think the family earns too much.
Benefits are comprehensive and designed around children's needs: routine check-ups, immunisations, doctor and hospital care, prescriptions, dental and vision care, mental health services, and lab and X-ray services. Under Medicaid, children receive Early and Periodic Screening, Diagnostic and Treatment (EPSDT), a broad entitlement to medically necessary care.
Costs are low. Many families pay nothing; others pay small monthly premiums or enrolment fees and small copayments, all capped at a modest share of family income. There are no charges for preventive care such as well-child visits and immunisations.
One application covers both programmes. When you apply, the state checks whether each child qualifies for Medicaid first and then for CHIP. You do not need to know which one fits.
Children's coverage under Medicaid includes a broad benefit called Early and Periodic Screening, Diagnostic and Treatment (EPSDT), which requires states to cover any medically necessary service for children, even if it is not covered for adults. Separate CHIP programmes have their own benefit package, which is comprehensive though not always as broad as EPSDT. Both include regular well-child check-ups, immunisations, dental, vision and mental health care.
Many states provide continuous eligibility for children, meaning a child stays covered for a full twelve months even if family income changes, and some states extend this for young children for several years. This avoids children losing coverage because of a temporary rise in a parent's earnings.
Who usually qualifies
Factors the agency looks at. Only they make the final decision.
Rules about children who have other insurance, waiting periods after dropping private coverage, and premiums vary by state.
How to apply, step by step
Apply through your state, InsureKidsNow or HealthCare.gov
Call 1-877-543-7669 (KIDS-NOW) or use InsureKidsNow.gov to find your state's programme. HealthCare.gov also screens children for Medicaid and CHIP.
List every child and the household's income
The state checks each child separately for Medicaid and CHIP.
Provide verification
Respond quickly to any request for income or citizenship documents.
Pay any premium if required
Some states charge small monthly premiums for CHIP.
Choose a plan and doctor
Pick a primary care provider and a dentist.
Schedule well-child and dental visits
Preventive care is free.
Renew each year
Watch for renewal notices.
What to have ready
Missing one item is rarely a reason to wait - start now.
- Children's birth certificates and Social Security numbers
- Proof of household income
- Proof of address
- Information about any current insurance
- Immigration documents for non-citizen children, if applicable
What happens after you apply
How it compares
Similar programmes, and which one fits which need.
| Programme | What it covers | Best for |
|---|---|---|
| CHIP | Low-cost coverage for children | Kids in families above Medicaid limits |
| Medicaid | Free or very low-cost full health coverage | Low-income adults, children, pregnancy, disability |
| ACA Marketplace | Private plans with income-based subsidies | People without affordable job-based coverage |
| School-based health centres | Care at school | Students needing convenient care |
Real situations
How this plays out for people in common circumstances.
Parents earn too much, kids qualify
A couple both work and earn above their state's adult Medicaid limit; their employers' family coverage is very expensive.
Their two children qualify for CHIP for a small monthly premium.
Self-employed family
A self-employed father buys individual coverage for himself.
His children are covered by CHIP at a fraction of the cost of adding them to his plan.
Child with asthma
A child needs regular inhalers and specialist visits.
CHIP covers prescriptions and specialist care with small copays.
Immigrant children
A family with lawfully residing children was told they must wait five years.
Their state covers lawfully residing children without the waiting period, so they apply.
Parents' income rose mid-year
A child is enrolled in CHIP when her father gets a raise in March.
Her state's 12-month continuous eligibility keeps her covered until the next renewal, avoiding a gap.
What people miss
True, rarely explained, and it changes the outcome.
Children qualify at higher incomes
Always apply for the kids.
Dental is included
Children's dental care is a core benefit.
Preventive care is free
No cost for check-ups and shots.
One application covers Medicaid and CHIP
You do not need to choose.
Apply any time
No enrolment period.
Common reasons people get stuck
Assuming the family earns too much
Apply for the children anyway.
Missing premium payments
Can lead to disenrolment in some states.
Not renewing
Watch for notices.
Not using dental benefits
Schedule visits.
Dropping coverage when income rises slightly
Ask about CHIP limits first.
How it differs by state
Each state sets its CHIP income limits, premiums and programme names. Some cover pregnant people and lawfully residing immigrant children without waiting periods.
Key terms explained
The words on forms and letters, in plain English.
- CHIP
- The Children's Health Insurance Program, covering children in families above Medicaid limits.
- EPSDT
- Medicaid's comprehensive children's benefit covering any medically necessary service.
- Continuous eligibility
- A rule keeping children covered for a full year (or longer in some states) despite income changes.
- Premium
- A monthly payment some CHIP programmes charge, capped by family income.
- Well-child visit
- A routine check-up for development, growth and immunisations, free under Medicaid and CHIP.
- Waiting period
- A gap some states require between dropping private coverage and enrolling a child in CHIP.
Questions people ask
What is CHIP?
How do I apply for CHIP?
What is the income limit for CHIP?
How much does CHIP cost?
What does CHIP cover?
Can I apply for CHIP any time?
Can my child get CHIP if I have insurance through work?
Does CHIP cover pregnant women?
What age does CHIP cover?
Can immigrant children get CHIP?
Is CHIP the same as Medicaid?
What happens when my child turns 19?
Can my child have CHIP and private insurance?
What if I cannot pay the CHIP premium?
Does CHIP cover braces?
Does CHIP cover therapy for children?
Can a child get CHIP if parents are undocumented?
Does CHIP cover college students?
Numbers to call
Free lines. We are not affiliated with any of them.
Official sources
Current figures and applications live here.