State Children's Health Insurance Program

Centers for Medicare & Medicaid Services (CMS) in

HIV/AIDS


December 19, 2018

Overview

The Children's Health Insurance Program (CHIP) is a partnership between the federal and state governments that provides low-cost health coverage to children in families that earn too much money to qualify for Medicaid. In some states, CHIP covers pregnant women. Each state offers CHIP coverage, and works closely with its state Medicaid program. CHIP benefits are different in each state. But all states provide comprehensive coverage, like routine check-ups, immunizations, doctor visits, and prescriptions. Check with your state for information about covered services.

Each state program has its own rules about who qualifies for CHIP. You can apply right now, any time of year, and find out if you qualify. If you apply for Medicaid coverage to your state agency, you’ll also find out if your children qualify for CHIP. You must check with the CHIP office in the state you live in to confirm if your family is eligible to get benefits. These programs may be called different names in your state. To find information about the Medicaid and CHIP programs in your state, visit InsureKidsNow.gov or call 1-877-KIDS-NOW (1-877-543-7669). When you call, you’ll be connected to someone in your state who can help you learn whether your children may qualify and help you enroll them.

Administration

State Children's Health Insurance Program is administered by Centers for Medicare & Medicaid Services (CMS).

Program Requirements:

For this benefit program, you must be under 19 or be a primary caregiver with a child under 19, not covered by health insurance (including Medicaid), and a U.S. national, citizen, legal alien, or permanent resident.

In order to qualify, you must have an annual household income (before taxes) that is below the following amounts:

Household Size* Maximum Income Level (Per Year)
1 $48,240
2 $64,960
3 $81,680
4 $98,400
5 $115,120
6 $131,840
7 $148,560
8 $165,280

*For households with more than eight people, add $16,720 per additional person. Always check with the appropriate managing agency to ensure the most accurate guidelines.

Eligibility depends on your income, the number of people in your family and the rules in your state. In almost every state, children in families with income up to 200 percent of the federal poverty level ($48,500 per year for a family of four) are covered. In more than half the states, the income eligibility for children can be even higher.

Depending on your income level, you may need to pay low premiums and cost-sharing for some services. The rest of the coverage is paid for by the federal government and your state.  See your state's program information for details.

 

Application Details

You can enroll in CHIP anytime, and can apply online, by phone, by mail or in person. You can apply using the online application or directly at your state’s Medicaid or CHIP agency.  For specific information about CHIP in your state, including steps to apply, visit InsureKidsNow.gov.

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