CHIP is a government health insurance program for children whose families earn too much for Medicaid but not enough to buy private insurance
CHIP stands for Children's Health Insurance Program. It covers doctor visits, hospital stays, prescriptions, and dental care for children under 19 in households that don't meet Medicaid income limits but can't afford commercial insurance. Each state runs its own CHIP program with slightly different names, income thresholds, and covered services — so what CHIP covers in Texas differs from what it covers in New York.
CHIP is jointly funded by federal and state money, which is why the program exists in every state but operates differently in each one. Your state's CHIP program is the place to start if you're looking for coverage for your children.
Key Takeaways
- CHIP covers children under 19 whose household income is above Medicaid limits but below a threshold your state sets — usually between 200% and 400% of the federal poverty line.
- Each state names and runs its own CHIP program, so you contact your state health department or visit your state's Medicaid website to learn the income limits and how to start.
- CHIP typically charges a small monthly premium (sometimes $0) and a copay for doctor visits, but covers preventive care like checkups and vaccines at no cost.
- Enrollment is open year-round in most states, unlike private insurance, so you can start coverage whenever your children need it.
How CHIP income limits work
CHIP income thresholds are set by each state and change yearly. Most states cover children in households earning between 200% and 400% of the federal poverty line — meaning a family of four might be may be able to access with an annual income somewhere between $55,000 and $110,000, though this varies significantly by state.
To find your state's exact income limit, go to your state health department website or call your state Medicaid office. They can tell you in minutes whether your household income falls within the range. Income limits are usually based on your household size and the income from the past month or the past year, depending on your state's rules.
What CHIP covers
CHIP covers the same basic services as Medicaid: doctor visits, hospital stays, emergency care, lab work, X-rays, prescriptions, dental care, vision care, and mental health services. Preventive care — checkups, vaccines, screenings — is covered at no cost to you. You pay a copay (usually $1 to $5) when you see a doctor or fill a prescription, and your state may charge a small monthly premium.
Some states cover more than others. A few states cover dental work and vision care more broadly than others do. Check your state's CHIP website to see the full list of what's covered under your program.
What each state calls CHIP
CHIP goes by different names in different states, which can make it harder to find. Here are some examples:
- California: Medi-Cal
- Florida: Florida Healthy Kids
- New York: Child Health Plus
- Pennsylvania: CHIP
- Texas: CHIP
If you search for "CHIP" in your state and nothing comes up, try searching for your state name plus "children's health insurance" or go directly to your state's Medicaid website. The state Medicaid office can tell you the correct name and how to contact the program.
How to find your state's CHIP program
Start at your state's Medicaid website. Most states have a single portal where you can learn about both Medicaid and CHIP, see income limits, and find contact information. You can also call your state health department directly — the number is usually on your state's official website.
If you're not sure which state office to contact, call 211 (a free referral service) and tell them you're looking for children's health insurance in your state. They can direct you to the right program. You can also visit insurekidsnow.gov, a federal site that links to every state's CHIP program and shows income limits for each state.
CHIP vs. Medicaid: the main differences
| Feature | CHIP | Medicaid |
|---|---|---|
| Who it covers | Children whose families earn too much for Medicaid | Low-income children, pregnant people, parents, elderly, disabled |
| Income limit | Usually 200–400% of federal poverty line | Usually up to 138% of federal poverty line (varies by state) |
| Monthly premium | Usually $0 to $50 | Usually $0 |
| Copay | Usually $1–$5 per visit | Usually $0–$3 per visit |
| Enrollment | Year-round in most states | Year-round in most states |
If your children don't meet your state's Medicaid income limit, CHIP is the next step. If they do meet the Medicaid limit, Medicaid is usually the better choice because it has lower or no copays and no premium.
What happens after you contact your state CHIP program
When you reach out to your state's CHIP program, they'll ask for your household income, your children's ages, and whether they have other insurance. Some states let you start the process online; others require a phone call or a paper form. You'll typically need to provide proof of income (a recent pay stub or tax return) and proof of your children's citizenship or immigration status.
Once your children are enrolled, you'll receive an insurance card in the mail. You can use it at any doctor, hospital, or pharmacy that accepts your state's CHIP insurance. If your income changes or your family situation changes, tell your state CHIP program — your coverage may change as a result.
Frequently Asked Questions
Can I enroll my children in CHIP if they already have private insurance?
Yes. If your private insurance is expensive or doesn't cover what your children need, you can switch to CHIP. You don't have to wait for open enrollment — CHIP enrollment is open year-round in most states. Tell your private insurer you're dropping coverage and enroll in CHIP.
What if my income changes after I enroll?
Contact your state CHIP program and report the change. If your income goes up, you may no longer be may be able to access and your coverage will end. If your income goes down, you may become may be able to access for Medicaid instead. If your income stays within the CHIP range, your coverage continues.
Do my children have to be citizens to get CHIP?
Rules vary by state. Most states cover U.S. citizens and may have access to immigrants. Some states cover children regardless of immigration status. Contact your state CHIP program with your children's immigration status and they'll tell you whether they're may be able to access.
Can I use CHIP insurance at any doctor?
CHIP insurance works like other health insurance — you can see any doctor or hospital that accepts your state's CHIP plan. When you call to make an appointment, ask if they take your CHIP insurance. If a doctor doesn't accept it, your state CHIP program can help you find one who does.
What if I can't afford the CHIP premium?
Many states waive the premium for families below a certain income level. Some states offer premium information programs. Contact your state CHIP program and explain your situation — they may be able to reduce or remove the premium.