CHIP: How Children's Health Insurance Works and How to Apply
The Children's Health Insurance Program — CHIP — was created in 1997 to address a specific gap: families with income too high for Medicaid but too low to afford private health insurance for their children. It now covers about 7 million children across the country. Despite its importance, many families who qualify for CHIP do not know about it or assume their children are uninsured. If your children are uninsured, CHIP is worth checking first — the income limits are higher than most people expect.
Written by the Uplift editorial team · Reviewed against official federal program sources
Who qualifies for CHIP
CHIP covers children up to age 19 in families with income too high for Medicaid but within the CHIP eligibility range. Income limits vary significantly by state. The federal minimum requires states to cover children up to 200% FPL, but many states have set limits much higher — some states cover children up to 300%, 350%, or even 400% FPL for the youngest children.
A family of four at 250% FPL earns roughly $78,000 per year in 2024. Many middle-income families are surprised to learn their children may qualify for CHIP. The key variable is your state's specific income limit and whether your current coverage is considered acceptable (some states deny CHIP if you have access to affordable employer coverage for your children).
CHIP has no open enrollment period. You can apply at any time of year. If your income changes during the year and your children lose other coverage, they can enroll in CHIP immediately without waiting for an open enrollment window.
What CHIP covers
CHIP must cover the same categories of services required under Medicaid's Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) benefit, which includes well-child visits, immunizations, dental care, vision care, hearing screening, mental health services, and substance use disorder treatment.
CHIP plans typically look like pediatric HMO or PPO coverage. Premiums vary by state and income — some states have no premiums for CHIP, others charge modest amounts (typically under $100 per family per month). Copays for doctor visits and prescriptions are generally low, capped at a percentage of family income.
Dental and vision coverage through CHIP is often more comprehensive than equivalent private insurance for children. Routine dental care — cleanings, X-rays, fillings — is a covered CHIP benefit in all states. Comprehensive vision examinations and glasses are also typically covered.
How CHIP interacts with Medicaid
CHIP and Medicaid use the same application form in most states. When you apply, the system checks eligibility for both programs and routes your child to the appropriate one based on income and family circumstances. Children below the Medicaid income limit are enrolled in Medicaid; children above that limit but within the CHIP range are enrolled in CHIP.
This coordination also means that if your income drops, your child may move from CHIP to Medicaid automatically at renewal without a new application. And if your income rises above the CHIP limit, your child will receive advance notice and information about Marketplace coverage before CHIP ends.
The CHIP waiting period — a requirement in some states that children be uninsured for a period (typically 90 days) before qualifying for CHIP — does not apply if the child is uninsured because they lost coverage involuntarily (job loss, end of employer coverage) or moved from another state.
How to apply
Apply at your state's combined benefits portal or directly at the state Medicaid/CHIP agency. Insurekidsnow.gov lists the application portal for every state. The application for CHIP uses the same information as a Medicaid application: household income, family composition, residency, and Social Security numbers for all household members.
If you are already enrolled in your state's insurance marketplace (Healthcare.gov), and your children's income qualifies them for CHIP, you may receive a notice directing you to apply for CHIP rather than a subsidized marketplace plan. Marketplace subsidies are not available for children who are eligible for CHIP, so checking CHIP eligibility first makes sense.
Renewing CHIP coverage is typically annual. You will receive a renewal notice before your child's coverage expires. If your household income or family circumstances have not changed significantly, renewal is usually straightforward. Respond promptly to renewal notices — allowing coverage to lapse creates a gap that affects your child's access to care.
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