Enrolling for CHIP: How to Get Low-Cost Health Coverage for Kids

How CHIP works

CHIP is paid for by the federal government and the states together. Each state runs its own program under federal rules, so income limits, costs and extra benefits are different from state to state.

Some states run CHIP as part of Medicaid. Others run a separate CHIP program, and some do both. You don't need to know which type your state uses. When you apply, the state checks your child for Medicaid and CHIP at the same time and enrolls them in whichever one fits.

In some states, CHIP also covers pregnant women. In others, pregnant women are covered through Medicaid instead.

Who qualifies for CHIP

Your state sets the exact rules, but in general a child can get CHIP if they:

• Are under age 19
• Live in the state where you apply
• Have household income within your state's CHIP limit
• Don't qualify for Medicaid
• Aren't already covered by a group health plan, such as insurance through a parent's job
• Are a U.S. citizen or have an eligible immigration status

A few groups are left out by federal rules. These include children who are inmates of a public institution and children who are patients in an institution for mental diseases when they apply or renew. In some cases, a child who can get a state employee health plan through a parent who works for a public agency is also excluded.

Income limits depend on your state

There is no single national income limit for CHIP. Each state sets its own limit as a percentage of the federal poverty level, and the limit can depend on the child's age.

CMS publishes a state-by-state table of Medicaid and CHIP income limits. The current version shows limits as of December 1, 2023. In that table, separate CHIP limits ranged from 185% of the poverty level in Idaho to 400% in New York, and several states cover all eligible children through Medicaid instead. Your state may have changed its limit since then, so confirm with your state agency.

The quickest way to get an idea for your family is the HealthCare.gov Medicaid and CHIP page. You enter your household size and state, and it tells you whether you might qualify for Medicaid, CHIP, or savings on a Marketplace plan. You can also use our benefit finder to check other programs at the same time.

Even if you think your income is too high, HealthCare.gov recommends applying anyway. The state makes the final call.

Immigration status

A recent change in federal law narrowed which immigration statuses qualify for full Medicaid or CHIP. According to HealthCare.gov, the statuses that now qualify are:

• Lawful Permanent Resident (green card holder)
• Cuban or Haitian entrant
• Compact of Free Association (COFA) migrant

Many qualified immigrants also face a 5-year waiting period. Some states have chosen to cover "lawfully residing" children and pregnant women without that wait. Medicaid.gov keeps a list of states that cover lawfully residing children and pregnant women, last updated April 2, 2026.

Rules for immigrant families are complicated and changing. If you're unsure, apply for your child anyway, or get free advice from a legal aid office through LawHelp.org.

What CHIP covers

Benefits differ by state, but every state's CHIP gives comprehensive coverage. According to HealthCare.gov, that includes:

• Routine check-ups and doctor visits
• Immunizations
• Prescriptions
• Dental and vision care
• Inpatient and outpatient hospital care
• Lab work and X-rays
• Emergency services
• Behavioral health services

Separate CHIP programs must cover well-baby and well-child visits, dental care, behavioral health care and vaccines. If your state runs CHIP as part of Medicaid, your child gets the full Medicaid benefit for children, which includes Early and Periodic Screening, Diagnostic and Treatment (EPSDT) services. EPSDT is meant to find and treat health problems as early as possible.

Some states add more benefits. Your state CHIP agency can tell you exactly what's covered.

What CHIP costs

Costs depend on your state and income. Some states charge a monthly premium, and you may owe copayments for some services. Here are the federal limits states must follow:

• Routine well-child doctor and dental visits are free.
• If your family income is above 150% of the poverty level, your total CHIP costs for the year can't go over 5% of your family's income.
• If your income is at or below 150% of the poverty level, premiums can't be higher than what Medicaid allows.
• American Indian and Alaska Native children can't be charged cost-sharing.
• States can't charge more than one kind of cost-sharing for the same service.

Your state must publish its current premiums and copays, so check your state agency's website or your approval letter for the exact amounts.

If you fall behind on a premium, the state has to give you notice and a chance to pay before dropping coverage. It also has to let you show that your income went down, which could move your child to Medicaid or a lower cost level. States can no longer make you wait out a lockout period or pay old premiums before your child can re-enroll.

How to apply for CHIP

There are two ways to apply. Both are free, and both lead to the same state decision.

Option 1: Apply through your state agency

1. Go to Medicaid.gov's state contact page and pick your state. It lists your state's Medicaid and CHIP agency, website and phone numbers.
2. Apply online, by phone, by mail or in person, depending on what your state offers.
3. Answer any follow-up requests from the state quickly.

When you apply to your state, the agency checks your children for both Medicaid and CHIP.

Option 2: Apply through HealthCare.gov

1. Create an account on HealthCare.gov and fill out a Marketplace application, or call the Marketplace Call Center at 1-800-318-2596 (TTY: 1-855-889-4325).
2. If it looks like your child qualifies for Medicaid or CHIP, HealthCare.gov sends your information to your state agency.
3. Your state agency contacts you about enrollment.

This route makes sense if other people in your household need coverage too. The same application shows whether adults qualify for Medicaid or for savings on a Marketplace plan.

What to have ready

HealthCare.gov's application checklist is written for Marketplace applications, but your state will ask for much of the same information:

• Name and date of birth for everyone in your household, including people not applying
• Home and mailing address
• Social Security numbers for each person who has one
• Immigration document information for any lawfully present immigrant applying
• How you file taxes and who you claim as a dependent
• Income for everyone in the household, such as pay stubs, W-2s, self-employment income, unemployment, or Social Security payments
• Information about any health coverage anyone has now, including policy numbers
• Employer information for anyone in the household with a job, including any job-based health plan they're offered

If you're missing something, you can still start the application. You may be asked for more information later.

What happens after you apply

Federal rules give the state up to 45 days to decide on most applications. The state can take longer if it is still waiting on information from you, so send anything it asks for right away.

You'll get a written notice either way. An approval notice should tell you when coverage starts, what you'll pay, and what changes you need to report. A denial notice must explain why and tell you how to ask for a review.

According to HealthCare.gov, if you qualify, coverage can start right away. If you need care before your card arrives, show your provider a copy of your eligibility letter so they can confirm you're enrolled. If you need a prescription filled, bring the letter to a pharmacy that accepts Medicaid or CHIP. Most pharmacies can give you enough medicine for 3 days if they can't confirm your coverage yet.

Keeping coverage: renewals and changes

Since January 1, 2024, states must give children under 19 a full 12 months of continuous coverage in Medicaid and CHIP. In most cases, your child stays covered for the whole year even if your income goes up during that time.

Your state will check eligibility again at renewal time. Watch your mail, email and texts from the state agency, and send back any renewal forms right away. You can check your renewal status by calling your state agency.

Tell your state agency about life changes it asks you to report, such as a new job, a move, or a change in who lives in your home.

If you move to another state

CHIP is run by each state, and your child must live in the state that covers them. If you move, apply in your new state as soon as you can, and let your old state know you've moved.

If your application is denied

You have the right to ask for a review of a CHIP denial, a delay in deciding your application, or a termination of coverage. Your denial notice explains how to request one. If you get a bill for something you think CHIP should cover, you can also ask your state to review it.

Before you appeal, read the notice closely. Income mistakes are common, such as counting income that doesn't belong or leaving out a household member.

When a state denies or ends Medicaid or CHIP coverage, it sends your information to the Marketplace, which will mail you a letter about other coverage. You don't have to wait for that letter. You can apply at HealthCare.gov or find free local help through localhelp.healthcare.gov.

If your income drops later, apply again. Your child may qualify for Medicaid.

Watch out for scams

You never have to pay anyone to apply for CHIP or keep coverage. HealthCare.gov warns not to give money or personal information to anyone who says you must pay them for Medicaid or CHIP. Trained Marketplace assisters help for free and will never ask for a credit card number.

CHIP and Medicaid compared

Feature	CHIP	Medicaid
Who it covers	Children under 19, and pregnant women in some states	Low-income children, families, pregnant women, older adults and people with disabilities
Income limits	Set by each state; CHIP picks up where the state's Medicaid limit for children ends	Set by each state; lower than CHIP limits
Costs to families	Free in some cases; premiums and copays allowed, capped at 5% of income for families above 150% of the poverty level	Free or low-cost, under Medicaid cost-sharing rules
Benefits	Comprehensive; separate CHIP must include well-child care, dental, behavioral health and vaccines	Comprehensive, including EPSDT for children
How to apply	Same application as Medicaid, through your state or HealthCare.gov	Same application as CHIP

Children in the same family can end up in different programs, because states often set Medicaid limits by age. A baby might get Medicaid while an older sibling gets CHIP. For adults in your home, see our guide on how to enroll in Medicaid.

If you have young children or are pregnant, you may also qualify for food help. Our guide to enrolling for WIC explains how to apply, and our page on the difference between SNAP and WIC shows how the two programs fit together.

Frequently asked questions

Is there an open enrollment period for CHIP?

No. You can apply for CHIP and Medicaid any day of the year. The Marketplace open enrollment period applies only to Marketplace plans.

Can my child get CHIP if I have insurance through my job?

Usually not, if your child is already covered by a group health plan. If your child isn't on your job-based plan, they may still qualify. The state checks this when you apply, and it can't make you wait a set period after you lose job-based coverage.

Can I buy a Marketplace plan for my child instead of using CHIP?

You can, but if your child is eligible for CHIP, they won't get any savings on a Marketplace plan. HealthCare.gov notes that CHIP will probably cost less. Other family members may still qualify for Marketplace savings.

How long does it take to get approved?

The state has up to 45 days to decide most applications. Delays often come from missing documents, so respond quickly to any request.

Do I need a Social Security number for my child?

The application asks for a Social Security number for each person who has one. If you don't enter one, you may need to give more information later.

Will I lose CHIP if my income goes up?

Children under 19 get 12 months of continuous coverage, so a raise during the year usually won't end your child's CHIP right away. At renewal, the state looks at your income again.

Sources

• Children's Health Insurance Program (CHIP), CMS (Medicaid.gov), accessed October 2026
• CHIP Benefits, CMS (Medicaid.gov), accessed October 2026
• CHIP Cost Sharing, CMS (Medicaid.gov), accessed October 2026
• Medicaid, Children's Health Insurance Program, & Basic Health Program Eligibility Levels, CMS (Medicaid.gov), accessed October 2026
• Continuous Eligibility for Medicaid and CHIP Coverage, CMS (Medicaid.gov), accessed October 2026
• Medicaid and CHIP Coverage of Lawfully Residing Children & Pregnant Women, CMS (Medicaid.gov), accessed October 2026
• Where Can People Get Help With Medicaid & CHIP?, CMS (Medicaid.gov), accessed October 2026
• The Children's Health Insurance Program (CHIP), HealthCare.gov, accessed October 2026
• Medicaid & CHIP coverage, HealthCare.gov, accessed October 2026
• Coverage for lawfully present immigrants, HealthCare.gov, accessed October 2026
• Using your new Medicaid or CHIP coverage, HealthCare.gov, accessed October 2026
• Get Marketplace coverage if you lose or are denied Medicaid or CHIP coverage, HealthCare.gov, accessed October 2026
• Get Ready to Apply for or Re-Enroll in Your Health Insurance Marketplace Coverage (PDF), HealthCare.gov, accessed October 2026
• 42 CFR 457.310, Targeted low-income child, eCFR, accessed October 2026
• 42 CFR 457.340, Application for and enrollment in CHIP, eCFR, accessed October 2026
• 42 CFR 435.912, Timely determination and redetermination of eligibility, eCFR, accessed October 2026
• 42 CFR 457.570, Disenrollment protections, eCFR, accessed October 2026
• 42 CFR 457.805, Procedures to address substitution under group health plans, eCFR, accessed October 2026
• 42 CFR 457.1130, Matters subject to review, eCFR, accessed October 2026