Children's Health Insurance Program (CHIP) Eligibility Requirements

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More info

• Medicaid & CHIP coverage
• Medicaid expansion & what it means for you
• The Children's Health Insurance Program (CHIP)
• Using your new Medicaid or CHIP coverage
• Changing from Marketplace to Medicaid or CHIP
• Get Marketplace coverage if you lose or are denied Medicaid or CHIP coverage

More info

The Children's Health Insurance Program (CHIP)

If your children need health coverage, they may be eligible for the Children's Health Insurance Program (CHIP).In certain states, CHIP provides low-cost health coverage to children and pregnant women in families that earn too much money to qualify for Medicaid. Each state offers CHIP coverage and works closely with its state Medicaid program.

Check if your children qualify and apply for CHIP

Each state program has its own rules about who qualifies for CHIP. You can apply any time of year and find out if you qualify. If you apply to your state agency for Medicaid coverage, you’ll also find out if your children qualify for CHIP. If they qualify, you won't have to buy an insurance plan to cover them.Notice: Apply any time You can apply for and enroll in Medicaid or CHIP any time of year. If you qualify, your coverage can start immediately.

2 ways to apply for CHIP:

• Call 1-800-318-2596 (TTY: 1-855-889-4325).
• Fill out an application. If it looks like anyone in your household qualifies for Medicaid or CHIP, we’ll securely 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 instead qualify for an individual insurance plan with savings based on your income. Create an account or log in to an existing account to get started.

What if my children are eligible for CHIP, but I would rather buy a Marketplace plan?

If your children are eligible for CHIP, they won't be eligible for any savings on a Marketplace plan. CHIP coverage will probably be more affordable. Remember, you and other family members may be eligible for savings on Marketplace coverage.

If my children can get CHIP but I don't qualify for Medicaid, how can I get coverage?

You may be able to get an insurance plan through the Marketplace. Check if you may qualify for savings.Create an account or log in to an existing account to get started. If it looks like anyone in your household qualifies for Medicaid or CHIP, we’ll send your information securely to your state agency. They’ll contact you about enrollment. When you submit your Marketplace application, you’ll also find out if you instead qualify for an individual insurance plan with savings based on your income.

What CHIP covers

CHIP benefits are different in each state. But all states provide comprehensive coverage, including:

• Routine check-ups
• Immunizations
• Doctor visits
• Prescriptions
• Dental and vision care
• Inpatient and outpatient hospital care
• Laboratory and X-ray services
• Emergency services
• Behavioral health services

States may provide more CHIP benefits. Learn more about covered services in your state. 

What CHIP costs

Routine "well child" doctor and dental visits are free under CHIP, but you may pay a copaymentCopaymentA fixed amount you pay for a plan-covered service, like $30 for other services. Some states charge a monthly premiumPremiumA monthly amount you pay for coverage whether you get services or not.  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.Email this pageEmailPrint this pagePrintBack to top