CHIP: Health coverage for children.
Children's Health Insurance Program (CHIP)
Federal-state health coverage for children in families that earn too much for Medicaid but cannot afford private insurance, covering doctor visits, hospital care, dental, vision, and prescriptions with low or zero copays.
Reviewed by SubhaVerified
Cost-sharing cap
5% of income
Federal cap on total family costs
Continuous coverage
12 months
Children stay enrolled for a year once approved
Decision deadline
45 days
Federal limit for most applications
Where to apply
Your state
Your state's CHIP or Medicaid office
Figures on this page were last verified October 16, 2026. Amounts and rules change, so confirm them with Centers for Medicare and Medicaid Services (CMS) before you apply.
What is CHIP?
CHIP (Children's Health Insurance Program) is a joint federal-state health-coverage program administered by CMS for uninsured children in families whose income is above their state's Medicaid limit but still moderate.
About 7.2 million people, mostly children, were enrolled in June 2026, per CMS reporting, making CHIP the second-largest public source of children's health coverage after Medicaid.
Income eligibility varies by state, with upper limits from about 190 percent of the federal poverty level in Idaho to 405 percent in New York (KFF, 2026, counting the standard 5-point income disregard); states set their own income tests, premium structures, and benefit designs within federal minimums.
Federal law caps total family cost sharing at 5 percent of annual family income and requires full coverage of pediatric preventive care with no copay. Seven states also use CHIP to cover pregnant women (KFF, January 2026).
Apply through healthcare.gov, your state Medicaid or CHIP portal, or by calling 1-877-543-7669 (1-877-KIDS-NOW).
The Children's Health Insurance Program (CHIP) is a joint federal-state program that provides comprehensive, low-cost health coverage to uninsured children in families whose income is too high to qualify for Medicaid but too low to afford private insurance.
Every state runs its own CHIP program under federal rules, and most states either combine it with Medicaid or run it as a standalone plan with its own name (Florida KidCare, Texas CHIP, PeachCare for Kids in Georgia, All Kids in Alabama).
CHIP covers children under age 19 and, in some states, pregnant women. Every state CHIP plan covers routine checkups, immunizations, doctor visits, hospital care, prescriptions, dental care, emergency services, lab and X-ray, and behavioral health. Most also cover vision.
Coverage is delivered through managed care organizations in most states, with the same provider networks the state uses for Medicaid.
In June 2026, about 7.2 million people were enrolled in CHIP nationwide, per the CMS Medicaid and CHIP enrollment data highlights. Income limits vary by state, from about 190% of the Federal Poverty Level (FPL) in Idaho to 405% FPL in New York's Child Health Plus.
KFF's figures count the standard 5-point income disregard, so New York's posted limit is 400% FPL.
Whether CHIP is free or low-cost depends on family income and state design. Families under 150% FPL pay no CHIP premiums, and any copays are kept very small by federal rules. Above that level, states may charge monthly premiums and copays for non-preventive services.
Federal law caps total cost sharing at 5% of family income across all CHIP-covered children in a household.
Which children and pregnant women CHIP covers
- Child must be under age 19 and a U.S. citizen, U.S. national, or lawfully present in the United States (some states cover DACA recipients and lawfully present immigrant children without a 5-year wait)
- Family income within the state's CHIP range, which starts above the state's Medicaid limit and tops out between about 190% and 405% of the Federal Poverty Level, depending on the state
- No waiting period. Federal rules ban states from making a child go without insurance before CHIP starts
- Not eligible for Medicaid based on income (Medicaid takes precedence if the child qualifies)
- Not covered by a state employee health plan that meets federal minimum standards (unless the plan would cost more than 5% of family income, triggering the hardship exception)
- Pregnant women may qualify for CHIP coverage in the seven states that use CHIP for pregnancy coverage: Colorado, Kentucky, Missouri, New Jersey, Rhode Island, Virginia and West Virginia
Only the agency that runs the program can decide eligibility.
For dollar figures by family size and state, see our guide to CHIP income limits by state.
What CHIP covers and what families may pay
Federal cost-sharing cap
5% of annual family income
About 7,198,008 people were enrolled in CHIP in June 2026, per the CMS Medicaid and CHIP enrollment data highlights. Combined with children's Medicaid, about 35 million children were covered by the two programs that month.
What the amount depends on
No CHIP family can be charged more than 5% of their annual gross income in combined premiums, copays, and other cost sharing across all children enrolled (42 CFR 457.560).
Well-child checkups, immunizations and routine preventive dental care are free of copays under federal rule.
Enrolling a child in CHIP
- 01
Find your state's CHIP program name and portal
CHIP goes by different names in different states. Look up your state's program at insurekidsnow.gov or call the national CHIP hotline at 1-877-KIDS-NOW (1-877-543-7669).
Common state names: Florida KidCare, Texas CHIP, PeachCare for Kids (Georgia), All Kids (Alabama), Child Health Plus (New York), Denali KidCare (Alaska), HUSKY Health (Connecticut).
- 02
Gather documents before you start the application
You will need proof of identity for each family member (birth certificate, driver's license, or state ID), proof of income for the last 30 days (pay stubs, tax return, unemployment statement), and proof of residency (utility bill, lease).
You will also need Social Security numbers or immigration documents for the child, and current health insurance information if any family member has coverage.
- 03
Apply through your state's CHIP portal, healthcare.gov, or by phone
Most states let you apply online through the same portal that handles Medicaid (BenefitsCal, Your Texas Benefits, MyACCESS Florida, etc.). You can also apply through healthcare.gov, which forwards CHIP applications to your state automatically.
Phone applications go through your state Medicaid agency or 1-877-KIDS-NOW. Paper applications can also be mailed to your state's Medicaid or CHIP agency.
- 04
Wait for the eligibility determination and enrollment packet
States must process CHIP applications within 45 days for standard applications, or within 90 days if disability determination is required.
Once approved, you will receive an enrollment packet listing the managed care plans available in your service area and the date your child's coverage starts.
- 05
Choose a health plan and pediatrician for your child
Most states deliver CHIP through managed care organizations (MCOs). Your state sets a deadline to choose an MCO, and if you miss it the state will auto-assign one.
Pick an MCO whose provider network includes your child's current pediatrician if possible, and confirm any specialist providers your child sees regularly are in-network.
- 06
Renew coverage annually
CHIP eligibility must be renewed every 12 months. States must first try to renew coverage using data they already have, such as tax and Medicaid records; when they cannot, they mail you a renewal form. Children keep CHIP for 12 months once enrolled, even if income changes.
Tell your state if your child gets other insurance or moves.
Start with the official source
Centers for Medicare and Medicaid Services (CMS)
CHIP questions from parents
Medicaid and CHIP both cover children, but they serve different income ranges. Medicaid covers children in families with the lowest incomes (typically under 138% to 200% FPL depending on state) and is federally mandated.
CHIP covers children in families that earn too much for Medicaid but still cannot afford private insurance (typically 138% to 400% FPL depending on state).
Coverage is very similar (both cover preventive care, hospital, dental, vision, prescriptions), but children's Medicaid is generally free, while CHIP may charge modest premiums and copays for higher-income families.
CHIP income limits vary by state and are set as a percentage of the Federal Poverty Level (FPL). Upper limits run from about 190% FPL in Idaho to 405% FPL in New York, counting the standard 5-point income disregard (KFF, 2026).
Using the 2026 poverty guidelines, 200% FPL for a family of four is $66,000 a year and 400% FPL is $132,000. Most states set eligibility between 200% and 300% FPL. Check your state's exact income limits at insurekidsnow.gov or your state Medicaid agency portal.
Families under 150% FPL pay no CHIP premiums. States can charge monthly premiums and copays for families above that level, and the amounts depend on your state and income tier. Federal law caps total combined cost sharing at 5% of family income across all CHIP-covered children in a household.
Well-child visits, immunizations and routine preventive dental care have no copay.
Every state CHIP plan covers routine checkups and immunizations, doctor visits, hospital care (inpatient and outpatient), prescriptions, dental care, laboratory and X-ray services, emergency services, and behavioral and mental health services. Most states also cover vision care.
Most states also cover speech therapy, occupational therapy, physical therapy, and durable medical equipment when medically necessary. Coverage is generally as comprehensive as private employer-based insurance.
CHIP itself is designed for children under age 19, but seven states use CHIP to cover pregnant women, and many more use a CHIP option to cover prenatal care from conception.
If your state does not offer CHIP for pregnant women, you may still qualify for pregnancy-related Medicaid or the healthcare.gov Marketplace. Adults without children generally cannot enroll in CHIP but may qualify for Medicaid expansion or Marketplace coverage with premium tax credits.
Sources & further reading
- Medicaid.gov: Children's Health Insurance Program (CHIP) overview
- Medicaid.gov: CHIP Eligibility & Enrollment
- CMS June 2026 Medicaid and CHIP Enrollment Data Highlights (7.2M in CHIP)
- ASPE: 2026 HHS Poverty Guidelines
- KFF: Medicaid and CHIP Income Eligibility Limits for Pregnant Women (January 2026)
- 42 CFR 457.805: No waiting period for CHIP enrollment
- Medicaid.gov: Medicaid, CHIP, and Basic Health Program Eligibility Levels by state
- Insure Kids Now (find your state CHIP program)
- 42 CFR 457.560: Aggregate cost-sharing limit (5% of family income)
- Healthcare.gov: The Children's Health Insurance Program (CHIP)
- KFF Medicaid and CHIP Enrollment Tracker
Use official sources to confirm current requirements and benefit amounts.
Reviewed by Subha
Every rule and figure here was checked against the sources above on October 16, 2026. Spotted something out of date? Tell us.
Not legal, tax, or financial advice. GrantsHubUSA is an independent editorial site. We are not a government agency and we do not run this program. See our full disclaimer.
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