The Children’s Health Insurance Program (CHIP) is a federally program for children whose families make enough money that they do not qualify for Medicaid, but struggle to pay for insurance through an employer or the marketplace. These low cost options help families afford reliable insurance for their children. If your children qualify, you do not need to purchase additional insurance for them. Your child can receive free or low cost health insurance through age 19.

Who qualifies for CHIP?

Each state manages its own Medicaid and CHIP programs, so there is not one consistent standard. When you apply, you will be told which program, if any, you qualify for. You must be denied for Medicaid to qualify for insurance coverage through CHIP.

Children and teens up to age 19 can be covered by CHIP. In some states, pregnant women also qualify. You must be a U.S. citizen or be lawfully residing in the U.S. to be eligible.

The income requirements change depending on the cost of living in each state. Your eligibility will be determined by your family size and income. Families making up to 200% of federal poverty guidelines are typically eligible ($48,000 for a family of four). In many states the limit is even higher.

How to apply for CHIP

You can apply through the federal health insurance marketplace and your information will be sent to your state’s office. They will contact you with more details on how to enroll your children in the program.

You can apply for CHIP through your state’s Medicaid system as well. To apply directly through your state’s program, use this map to find the office for you state.

Unlike other federal health insurance programs, there is not a set enrollment period. You can apply and enroll in CHIP at any time of the year that you qualify and need coverage. If your employment status or income changes, you can apply immediately for medical coverage for your children.

Information that you will need in order to apply for CHIP is:

  • Personal information for all household members (social security numbers and birth dates)
  • Income from all sources
  • Daycare expenses
  • Work transportation expenses
  • Information for any private insurance your household had in the past 90 days

What does CHIP cover?

While the exact coverage varies from state to state, all the programs must include “comprehensive coverage” that includes:

  • Well child visits (These will always be free)
  • Immunizations
  • Prescriptions
  • Dental care (Also always provided at no cost)
  • Vision care
  • Inpatient and outpatient services
  • Lab work and testing
  • X-rays and imaging
  • Emergency services
  • Mental health care

In some states, families covered by CHIP pay a small monthly premium for insurance. It is guaranteed that this premium will never be more than 5% of your monthly income. Each state also has the option to impose co-payments for services other than well child and dental visits.

However, these payments are always more affordable than insurance you purchase through an employer or the marketplace. CHIP is intended to be affordable for low to moderate income families to ensure that all children have access to important routine health care.

For more information on the qualifications and requirements in your state, visit the website or office location of your local Health and Human Resources of Job and Family Services.

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