The short answer
The Children's Health Insurance Program, CHIP, provides low-cost health coverage to uninsured children under 19 in families that earn too much for Medicaid but cannot easily afford private insurance. It is run by each state with federal funding, sometimes under its own name or as part of Medicaid, so the income limit varies by state, from about 170 percent of the federal poverty line to as high as 400 percent. In 2026, 200 percent of the poverty line is $66,000 a year for a family of four. Coverage includes check-ups, immunizations, doctor visits, prescriptions, hospital care, mental health care, and dental and vision care. Many states charge no premium, and total costs are generally capped at 5 percent of family income. Since 2024, children keep coverage for a full 12 months even if family income changes. You can apply any time of year, through your state agency or HealthCare.gov.
Could your child qualify?
A child can usually get CHIP if all of these are true:
- Age: under 19.
- Income: above your state's Medicaid limit for children but within its CHIP limit, which ranges from about 170 to 400 percent of the poverty line.
- Coverage: uninsured. Some states require a short waiting period if a child recently dropped private coverage, with exceptions such as a parent's job loss.
- Residence and status: living in the state, and a U.S. citizen or qualified immigrant. Many states also cover lawfully residing children without the usual five-year wait.
The income line is higher than most parents expect. In 2026, 200 percent of the poverty line is $66,000 a year for a family of four, and many states set their CHIP limit above that. A family of four earning $70,000 a year, about 212 percent of poverty, would be over the Medicaid line in most states but within CHIP in a state whose limit is 300 percent.
Where your children's coverage usually comes from
| Family income | Usually covered by |
|---|---|
| Up to at least 133% of the poverty line, and higher in many states | Medicaid, in every state |
| Above the state's Medicaid limit, up to its CHIP limit (about 170% to 400%) | CHIP |
| Above the CHIP limit | A parent's job-based plan or a Marketplace plan |
States set up CHIP in one of three ways: as an expansion of Medicaid, as a separate program with its own name and rules, or as a combination. Either way, a family usually fills out one application and the state decides which program fits. Check the Medicaid income test for your household as a first step.
Why the program your child lands in matters a little
The differences show up in cost and benefits. Medicaid rarely charges premiums and covers every service a child needs under its screening and treatment guarantee for children. A separate CHIP program may charge modest premiums or copays and sets its own benefit package, which must still include dental care. If your income drops during the year, report it: a child in CHIP may be able to move to Medicaid, which can lower costs further.
What CHIP covers
Coverage is designed for children and typically includes:
- Well-child visits, check-ups and immunizations.
- Doctor and specialist visits, emergency care and hospital stays.
- Prescription drugs, lab tests and X-rays.
- Mental and behavioral health services.
- Dental care, which every state's CHIP must cover, and vision care.
The exact benefits depend on your state's plan, and the state's CHIP handbook lists them. Coverage for braces and other orthodontic care varies, so ask about it if your child may need it.
What it costs
Many states charge no premium at all. Where a state charges premiums, enrollment fees or copayments, federal rules generally cap a family's total costs at 5 percent of its income for the year. Well-child visits and immunizations are free, and American Indian and Alaska Native children pay no premiums or cost-sharing.
For a family earning $70,000, that cap means CHIP can cost no more than $3,500 for the year, and often far less. Compare that with adding children to a job-based plan, where family premiums alone can run much higher.
Using the coverage once you have it
In many states, CHIP and Medicaid for children are delivered through private managed care plans, so after approval you may be asked to choose a plan and a primary care provider. If you do not choose, the state may assign one. Before picking, check that your child's pediatrician, dentist and any specialists are in the plan's network, and ask how referrals work.
Then use it. Schedule the well-child visit and a dental check-up soon after coverage starts; both are free, and they are often how problems with vision, hearing, teeth or development are caught early. Keep the member card with your other documents, since a school, camp or urgent care clinic may ask for it.
A full year of coverage, once enrolled
Since January 1, 2024, states must give children under 19 twelve months of continuous eligibility in both Medicaid and CHIP. Once enrolled, a child generally keeps coverage for a full year even if family income rises, with limited exceptions such as moving out of state or turning 19. A parent's raise in March does not cost a child coverage until the next renewal.
At renewal, the state checks eligibility again, often using information it already has. Read every renewal notice and return forms on time, because a missed renewal is a common reason children lose coverage.
Situations that change the answer
A parent has job-based coverage
Children with other health insurance generally cannot enroll in CHIP. But if covering the family through a parent's job is too expensive, family members may qualify for Marketplace subsidies based on the cost of family coverage, and some states help pay employer premiums for eligible children; see Marketplace subsidies.
A child has a disability or special health needs
Children with significant disabilities may qualify for Medicaid regardless of their parents' income, through SSI or state options that look only at the child's income, which can cover more services than CHIP. Ask the state about these routes.
Pregnancy and new babies
Some states use CHIP to cover prenatal care, and nearly all states now cover new mothers for 12 months after birth through Medicaid or CHIP. A baby born to a mother covered by Medicaid or CHIP is generally covered for the first year.
Applying, any time of year
You do not have to wait for an enrollment period. Apply through your state's Medicaid or CHIP agency, or through HealthCare.gov, which checks whether a child qualifies for Medicaid, CHIP or a Marketplace plan and routes the application. For help finding where to apply, call 1-800-318-2596 or visit InsureKidsNow.gov.
Have the household's income information, Social Security numbers or immigration documents for those applying, and the children's birth dates. A parent does not have to give their own immigration status to apply for a child, and a grandparent or other relative raising a child can apply on the child's behalf. Some states enroll children automatically using SNAP or school meal records. If a child loses other coverage, apply right away; special enrollment periods cover the rest of the family.
Common questions
Who is eligible for CHIP?
Uninsured children under 19 whose family income is above the state's Medicaid limit but within its CHIP limit, and who meet residency and citizenship or immigration requirements.
Can I apply for CHIP at any time of year?
Yes. Medicaid and CHIP accept applications all year, and you do not have to wait for Marketplace open enrollment.
How much does CHIP cost?
It depends on the state. Many charge no premium. Where there are premiums or copayments, federal rules generally limit the total to 5 percent of family income.
Can my child have CHIP and private insurance at the same time?
Generally no. CHIP is for uninsured children. If you are paying for private coverage you can no longer afford, ask the state whether your child qualifies once that coverage ends.
Does CHIP cover dental care?
Yes. Every state's CHIP program must include dental coverage for children, and most also cover vision care.
State by state
Income limits, premiums and covered services are set by each state and change over time, and eligibility for immigrant children depends on their status and the options the state has chosen. Your state agency or Medicaid.gov has the current figures. Our calculator checks the adult Medicaid income test, not CHIP.
Official sources
If your children are uninsured today
Start an application through your state agency or HealthCare.gov, which will route it to Medicaid or CHIP. Coverage questions about the adults in the household come next: check the Medicaid income test, and if your income is above it, look at Marketplace plans.
