What Is CHIP?

The Children's Health Insurance Program (CHIP) is a federally funded, state-administered program that provides affordable health coverage to children in families with incomes too high to qualify for Medicaid but too low to comfortably afford private insurance. In many states, CHIP also covers pregnant women.

CHIP and Medicaid work side by side, and in many states they share the same application process. Together, they form the backbone of public health coverage for American children.

Who Is Eligible for CHIP?

Eligibility varies by state, but in general:

  • Children must be under age 19
  • Family income must be above the Medicaid limit but below the state's CHIP income limit (often between 200% and 300% of the federal poverty level)
  • Children must be U.S. citizens or eligible immigrants
  • Children must not be currently covered by other qualifying insurance

Some states also offer CHIP coverage to pregnant women, covering prenatal care and delivery services regardless of immigration status.

What Does CHIP Cover?

CHIP coverage is comprehensive. Depending on your state, it typically includes:

  • Regular checkups and well-child visits
  • Immunizations and vaccinations
  • Doctor and specialist visits
  • Prescription medications
  • Dental and vision care
  • Inpatient and outpatient hospital services
  • Mental health and behavioral health services
  • Emergency care
  • Lab tests and X-rays

How Much Does CHIP Cost?

CHIP is designed to be affordable. Costs vary by state and family income, but generally include:

  • Low or no premiums for most families
  • Low copayments for office visits and prescriptions
  • No cost sharing for preventive services and immunizations

Families with the lowest incomes typically pay nothing. Federal rules also cap total out-of-pocket costs to ensure they remain manageable.

How CHIP Is Structured: Two Models

States implement CHIP in one of three ways:

  1. Medicaid expansion CHIP — The state expands its Medicaid program to cover more children under Medicaid rules.
  2. Separate CHIP program — The state runs a standalone program with its own rules and benefits.
  3. Combination approach — Some children are covered under expanded Medicaid, while others are in a separate CHIP program.

How to Apply for CHIP

Applying for CHIP is straightforward, and enrollment is year-round — there is no open enrollment period for CHIP or Medicaid.

  1. Visit InsureKidsNow.gov and enter your state to find your local program.
  2. Apply online, by phone, by mail, or in person at your local Medicaid office.
  3. Provide documentation of income, residency, and the child's age/citizenship status.
  4. Receive a determination — typically within 45 days (or 90 days if citizenship verification is needed).

What If My Child Was Turned Down for Medicaid?

If your child is found ineligible for Medicaid during the application process, the agency is required to automatically screen them for CHIP eligibility. You should not need to submit a separate application.

Key Resources

  • InsureKidsNow.gov — Find your state's CHIP program
  • Medicaid.gov/chip — Federal CHIP information
  • 1-877-KIDS-NOW — Free helpline for families

CHIP is one of the most successful public health programs in U.S. history, helping ensure millions of children have access to the care they need to grow up healthy.