CHIP vs. Medicaid for Children — What's the Difference?

Medicaid covers children with the lowest incomes at no cost. CHIP covers children in moderate-income households at low cost with small premiums and copays. Both programs apply year-round with no open enrollment period.

Healthcare

Children's Health Insurance (CHIP)

Low-cost health coverage for children in families above Medicaid limits.

View program →
Healthcare

Medicaid

Free or low-cost health coverage for low-income individuals and families.

View program →
Attribute
Children's Health Insurance (CHIP)
Medicaid
Who it covers
Children in moderate-income families
Children (and adults) in low-income families
Typical income limit (children)
200-300% FPL (varies by state)
Up to 138-200% FPL (varies by state)
Premiums
Low monthly premiums in most states
None for children
Copays
Small copays for some services
None or minimal for children
Coverage
Comprehensive — preventive, dental, vision, mental health
Comprehensive — preventive, dental, vision, mental health
Enrollment period
Year-round
Year-round
Dental coverage
Yes
Yes
Application
Through state Medicaid agency or healthcare.gov
Through state Medicaid agency or healthcare.gov
Who administers
State (jointly funded by federal government)
State (jointly funded by federal government)

Can you receive both?

A child qualifies for either Medicaid or CHIP based on household income — not both at the same time. Children with incomes below the Medicaid limit go on Medicaid (free); those with incomes above the Medicaid limit but below the CHIP limit go on CHIP (low-cost). You apply for both through the same application and the system determines which applies.

Which should you apply for?

Apply for both using the same application at healthcare.gov or your state Medicaid office. The system will automatically route your child to the correct program. Medicaid is completely free and covers more; CHIP has modest costs but still covers far more than private insurance at comparable income levels.

Frequently Asked Questions

How do I know if my child qualifies for Medicaid vs. CHIP?

It depends on your household income relative to the Federal Poverty Level in your state. Generally, children below 138-200% FPL qualify for free Medicaid, and children from 138-300% FPL qualify for CHIP. You do not need to determine this yourself — the joint application at healthcare.gov or your state's benefits portal will determine which program your child qualifies for.

Can my child lose CHIP coverage if my income increases?

Yes. If your household income rises above your state's CHIP limit, your child will no longer qualify. However, you have a special enrollment period to apply for marketplace insurance when your child loses CHIP coverage. Report income changes to your state agency as required.

Are immigrant children eligible for CHIP or Medicaid?

Lawfully present immigrant children may qualify for CHIP and Medicaid in most states after a 5-year waiting period. However, more than 30 states have chosen to provide CHIP coverage to lawfully present immigrant children and pregnant women without the 5-year wait using state funds. Undocumented children are generally not eligible for CHIP or Medicaid except for emergency services, though some states have state-funded programs.