Understanding the Children’s Health Insurance Program

If you’re searching for low-cost health insurance for your children, see if your family qualifies for the Children’s Health Insurance Program (CHIP). But who is eligible, and how do you apply? Here are the basics on CHIP.

What Does CHIP Mean?¹

The acronym CHIP means Children’s Health Insurance Program, which is a federal healthcare program that provides low-cost coverage to children whose families earn too much to qualify for Medicaid. Qualifying for CHIP means you won’t have to buy an Affordable Care Act (ACA) marketplace plan to cover your child or children.

How Is CHIP Different From Medicaid?¹

CHIP helps provide coverage to children, specifically, while Medicaid is mainly for families. If your income is too much to qualify for Medicaid, CHIP can step in to offer your children low-cost healthcare coverage options.

Do All States Have CHIP?^1,2

Yes, all states have their own version of CHIP, and coverage varies by state. CHIP works closely with your state Medicaid program to determine your specific coverage options. Medicaid and CHIP are both public insurance programs that cover children and are jointly funded by state and federal funds.

What Services Does CHIP Cover?²

CHIP offers comprehensive coverage, regardless of where you live. CHIP coverage includes the following benefits:

• Routine check-ups
• Visits to your doctor
• Emergency services
• Inpatient and outpatient hospital care
• Prescriptions
• Immunizations
• Dental and vision care
• Laboratory and X-ray services

Some states may provide additional CHIP benefits.

Who Is Covered Under CHIP?³

In most states, CHIP covers children up to age 19 in families of four with an annual income of $50,000. Coverage eligibility applies to U.S. citizens and certain lawfully present immigrants. Children are eligible even if one or both parents are employed.

Parents, grandparents, or other legal guardians can apply on behalf of children. In some states, teens living alone can apply for themselves.

What Is the Income to Qualify for CHIP?²

The income to qualify for CHIP varies by state, but enrollees will not pay more than 5% of their families’ annual income. Routine doctor and dental visits for “well children” are free of charge under CHIP, but there may be copayments for other services. Your state may also charge a monthly premium for CHIP coverage.

When Is the Enrollment Period for CHIP Coverage?²

You can apply to enroll in CHIP at any time. Unlike Affordable Care Act (ACA) plans enrollment, there is no designated period to enroll. Your child/children will be covered immediately once your state determines eligibility.

How Do I Apply for CHIP?²

Your state program has specific guidelines to determine who qualifies for CHIP. To apply, go through your state agency or call 1-800-318-2596 (TTY: 1-855-889-4325).

If your family doesn’t qualify for CHIP, you can still explore all your coverage options. Get started.