CHIP Income Limits 2026: Children's Health Insurance Eligibility by State

The Children’s Health Insurance Program (CHIP) is a joint federal and state program that covers uninsured children whose family income is too high to qualify for Medicaid but too low to afford private health insurance. Unlike Medicaid, CHIP has no single national income limit; each state sets its own ceiling, with federal rules allowing eligibility from 170 percent of the federal poverty line (FPL) up to 400 percent FPL.

For a family of four in 2026, that means CHIP could cover children earning anywhere from $56,100 (170 percent FPL) up to $132,000 (400 percent FPL) depending on which state you live in. This guide explains how CHIP eligibility actually works, what your state’s income limit is likely to be, what CHIP covers, what it costs, and how to apply through one combined Medicaid plus CHIP application.

What is CHIP?

CHIP was created in 1997 as Title XXI of the Social Security Act to close the coverage gap for working families who earned too much for Medicaid but could not afford private insurance. Today CHIP covers roughly 7 million children nationwide and is jointly funded by the federal government (which covers an enhanced match rate higher than regular Medicaid) and the states (which administer the program directly).

Every state operates its own CHIP program with its own name, its own income rules, and its own covered benefits, but all programs must meet minimum federal standards. States that operate CHIP as a Medicaid expansion give children the same benefits as regular Medicaid. States that operate CHIP as a separate program design their own benefit package.

What are the CHIP income limits in 2026?

The CHIP statute caps eligibility at the higher of 200 percent FPL or 50 percentage points above the state’s Medicaid level as it existed in 1997. In practice, many states have expanded above the federal floor. As of 2026, state CHIP eligibility levels range from 170 percent FPL to 400 percent FPL.

The table below shows what each FPL multiplier looks like in real dollars for tax year 2026, using the federal poverty guidelines published by HHS on January 15, 2026.

Family size	100% FPL	200% FPL	300% FPL	400% FPL
1	$15,960	$31,920	$47,880	$63,840
2	$21,640	$43,280	$64,920	$86,560
3	$27,320	$54,640	$81,960	$109,280
4	$33,000	$66,000	$99,000	$132,000
5	$38,680	$77,360	$116,040	$154,720
6	$44,360	$88,720	$133,080	$177,440

To find your state’s exact CHIP income limit, use the eligibility checker on healthcare.gov or contact your state’s CHIP agency directly. The federal Medicaid.gov website maintains a table of every state’s Medicaid and CHIP eligibility level by population group.

Who is eligible for CHIP?

CHIP serves three federally defined populations, with states choosing which ones to cover: targeted low-income children, targeted low-income pregnant women, and the From-Conception-to-End-of-Pregnancy (FCEP) option for prenatal care to noncitizen mothers.

Targeted low-income children must be under 19, uninsured (not eligible for Medicaid and not covered by group health insurance or other creditable coverage), U.S. citizens or qualified noncitizens, and residents of the state. They must also fall within the state’s CHIP income range.

States may also cover pregnant women under separate CHIP programs if they already cover children up to 200 percent FPL under Medicaid or CHIP and cover pregnant women up to 185 percent FPL under Medicaid. Infants born to women on CHIP are automatically deemed eligible for Medicaid or CHIP until age 1 without a separate application.

What does CHIP cover?

Federal rules require every state CHIP program to cover a comprehensive benefit package including routine well-child checkups, immunizations, doctor visits, prescriptions, dental and vision care, inpatient and outpatient hospital care, laboratory and X-ray services, emergency services, and behavioral and mental health services.

Many states cover additional services beyond the federal minimum, such as physical therapy, speech therapy, occupational therapy, hearing aids, and home health care. Coverage details vary by state, so check your state’s specific CHIP benefits package on the Medicaid.gov “Where Can People Get Help with Medicaid and CHIP” tool.

What does CHIP cost?

CHIP is free or low cost. Routine well-child doctor visits and dental checkups are always free under federal CHIP rules. Some states charge copayments for other services (typically $5 to $30 per visit) and a few states charge monthly premiums (typically $5 to $50 per child) for families above certain income levels.

Federal law caps total CHIP out-of-pocket spending at 5 percent of your annual family income. That means a family earning $40,000 cannot pay more than $2,000 in combined premiums, copayments, and other CHIP cost-sharing in a year. States must track this cap and stop billing once you reach it.

How do you apply for CHIP?

The fastest way to apply is through the federal HealthCare.gov Marketplace. When you fill out a Marketplace application, the system automatically checks whether anyone in your household qualifies for Medicaid or CHIP and securely forwards your information to your state agency. The state then contacts you about enrollment.

You can also apply directly with your state Medicaid agency by phone, online, or in person. Call 1-800-318-2596 (TTY 1-855-889-4325) to be routed to your state’s enrollment office. CHIP enrollment is open year round; there is no annual open enrollment period like there is for Marketplace plans.

Documents you will need

Most CHIP applications require proof of your child’s age (birth certificate or passport), proof of citizenship or qualified noncitizen status for each applicant, proof of residence in the state (utility bill, lease, or other current address documentation), proof of income for the last 30 to 90 days (pay stubs, tax return, or self-employment records), and information about any current health insurance the child has or could have through a parent’s employer.

Can I switch from a Marketplace plan to CHIP?

Yes. If your child becomes CHIP eligible while enrolled in a Marketplace plan with subsidies, the CHIP eligibility actually disqualifies the child from receiving any Marketplace premium tax credit. CHIP coverage will almost always cost less than a Marketplace plan after this subsidy loss, so switching to CHIP is usually the better financial choice.

You do not need to wait for open enrollment to make this change. Losing or gaining CHIP eligibility is a qualifying life event that opens a special enrollment period for both the Marketplace and CHIP, and the transition can be made any time of year.

What is the 5-year waiting period for noncitizen children?

Federal law generally imposes a 5-year waiting period before many lawfully present immigrant children can enroll in Medicaid or CHIP, even if they meet all other eligibility criteria. The waiting period applies to many lawful permanent residents (green card holders) and other qualified noncitizens.

However, states have the option to waive the 5-year wait for lawfully present children and pregnant women using a provision called the Immigrant Children’s Health Improvement Act (ICHIA). As of 2026, roughly 35 states plus DC have adopted this waiver. Check Medicaid.gov’s “Coverage of Lawfully Residing Children and Pregnant Women” page for the current state list.

What changed for incarcerated youth in 2025?

Under the Consolidated Appropriations Act of 2023, effective January 1, 2025, states can no longer terminate a child’s CHIP enrollment solely because the child becomes incarcerated. States may suspend coverage during incarceration but must reinstate it on release. A new exception lets CHIP cover incarcerated youth within 30 days before their scheduled release, so they have active coverage on the day they leave detention.

States are also now required to process any CHIP application or redetermination filed on behalf of an incarcerated child before release. This change is one of the biggest CHIP eligibility expansions in years and was designed to prevent the gap in coverage that historically left youth uninsured during the high-risk period immediately after release from juvenile detention.