Children's Health Insurance Program (CHIP) Eligibility Requirements
If your children need health coverage, they may be eligible for the Children's Health Insurance Program (CHIP). If they qualify, you won't have to buy an insurance plan to cover them.
CHIP provides low-cost health coverage to children in families that earn too much money to qualify for Medicaid. In some states, CHIP covers pregnant women. Each state offers CHIP coverage, and works closely with its state Medicaid program.
See if your children qualify and apply for CHIP
Each state program has its own rules about who qualifies for CHIP. You can apply right now, any time of year, and find out if you qualify. If you apply for Medicaid coverage to your state agency, you’ll also find out if your children qualify for CHIP.
2 ways to apply for CHIP:
- Call 1-800-318-2596 (TTY: 1-855-889-4325).
- Fill out an application through the Health Insurance Marketplace. If it looks like anyone in your household qualifies for Medicaid or CHIP, we’ll send your information to your state agency. They’ll contact you about enrollment. When you submit your Marketplace application, you’ll also find out if you qualify for an individual insurance plan with savings based on your income instead.
FYI You can apply for and enroll in Medicaid or CHIP any time of year. There’s no limited enrollment period for either Medicaid or CHIP. If you qualify, your coverage can start immediately.
What CHIP covers
CHIP benefits are different in each state. But all states provide comprehensive coverage, including:
- Routine check-ups
- Doctor visits
- Dental and vision care
- Inpatient and outpatient hospital care
- Laboratory and X-ray services
- Emergency services
States may provide more CHIP benefits. Check with your state for information about covered services.
What CHIP costs
Routine "well child" doctor and dental visits are free under CHIP. But there may be copayments for other services. Some states charge a monthly premium for CHIP coverage. The costs are different in each state, but you won’t have to pay more than 5% of your family's income for the year.
- What if my children are eligible for CHIP, but I would rather buy a Marketplace insurance plan?
If your children are eligible for CHIP, they won't be eligible for any savings on Marketplace insurance. CHIP coverage will probably be more affordable. Remember, you and other family members may be eligible for savings on Marketplace insurance coverage.
- If my children can get CHIP but I don't qualify for Medicaid, how can I get insured?
You may be able to get an insurance plan through the Marketplace, with savings based on your income.
- Visit our Get Coverage page, select your state, and select the "Apply Now button to fill out an insurance application through the Health Insurance Marketplace. If it looks like anyone in your household qualifies for Medicaid or CHIP, we’ll send your information to your state agency. They’ll contact you about enrollment. When you submit your Marketplace application, you’ll also find out if you qualify for an individual insurance plan with savings based on your income instead.
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