Health Care & Medicare Help › Guide
CHIP Health Coverage When Kids Do Not Qualify for Medicaid
CHIP may cover a child when family income is too high for Medicaid but private health cover costs too much. The program is open all year, and applying is free.
Each state sets its own income limit and costs. One form can check a child for Medicaid and CHIP.
Who may get CHIP?
CHIP is for eligible children up to age 19. A child must live in the state and meet its income and other rules.
A parent can have a job and still apply. In most states, a family of four with yearly income up to about $80,000 may get Medicaid or CHIP. Some state limits are higher or lower.
Do not use that example as a promise. Family size, state, income type, and other health cover can affect the choice.
What does CHIP cover?
CHIP gives broad child health cover. It includes:
- Checkups and shots
- Doctor and clinic care
- Medicine
- Dental and eye care
- Mental health care
- Lab tests and X-rays
- Hospital and emergency care
A state may add more care. Ask when cover starts and which doctors, dentists, drugs, and clinics are in the plan.
How much does CHIP cost?
Some families pay no premium. Others may pay a monthly bill, an enrollment fee, or a small copay. The amount depends on the state and income.
Under the federal rule, a family's CHIP premiums and copays cannot be more than 5% of family income for the year. There is no copay for routine well-child doctor and dental visits.
Save each bill and copay note. Call the state if the total seems too high.
Can a pregnant person get CHIP?
Some states use CHIP funds to cover care during pregnancy. The rules and name differ by state.
A person may also fit pregnancy Medicaid even if they did not fit Medicaid before. Apply instead of trying to pick the program yourself.
Can you apply at any time?
Yes. Medicaid and CHIP do not use the yearly Marketplace sign-up window. You can apply after a job loss, birth, move, or health need.
Coverage must be renewed. Keep your address, phone, and email up to date so you do not miss the form.
What should you gather?
- Names and birth dates for the home
- Pay stubs and other income facts
- Social Security numbers when asked
- Citizenship or immigration proof for people who apply
- Facts about other health cover
- A safe mailing and email address
A parent can apply for a child even if the parent is not seeking cover. The state should only ask for the facts needed to check the person who applies.
How do you apply?
- Use InsureKidsNow.gov to find your state.
- Apply on the state site or through HealthCare.gov.
- Or call 1-877-KIDS-NOW for state help.
- Send any missing proof by the due date.
- Save the decision and plan cards.
The form is free. Our Medicaid guide explains how the two programs connect.
What if your child is not approved?
Read the reason. Check the family size, income, and state facts. Ask how to seek a fair hearing if a fact is wrong.
If income is above the CHIP limit, check a Marketplace plan. You may get a tax credit. You can also use our poverty level guide to learn why program limits differ.
Run your numbers. The free Medicaid calculator shows your state's Medicaid income test — with a straight answer if your state did not expand. Nothing you type is saved. All calculators →
Application toolkit · verified 2026-07-28
Get ready to apply for CHIP
One application generally checks children for both Medicaid and CHIP. Your state may ask for additional proof.
Common documents and information
Check off items as you gather them. Do not send original records unless the agency specifically tells you to.
What happens after you apply
- Save the application ID, submission date, and a copy of the application.
- The Marketplace or state checks both Medicaid and CHIP. If the Marketplace transfers the case, the state contacts you about enrollment.
- Send requested documents by the deadline and read the eligibility letter carefully.
- If approved, use the letter or enrollment card to follow the state's health-plan instructions. If denied, review the appeal instructions and Marketplace alternatives in the notice.
Applying is free. CalculateBenefits does not receive or submit your application.
Local rules: CHIP income ranges, premiums, application documents, and plan enrollment are set by each state.
Sources
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