Free or Low-Cost Health Coverage for Kids: A Practical Guide to the Children’s Health Insurance Program (CHIP)

The Children’s Health Insurance Program (CHIP) is ongoing health coverage for eligible children in the United States. It is not a one-time grant, scholarship, or annual competition. Families can apply throughout the year, and the state Medicaid agency decides whether a child qualifies for Medicaid, CHIP, or another coverage route.

The program is designed for a common gap: a child’s family income is too high for Medicaid but still makes private or employer-sponsored coverage difficult to afford. CHIP is a joint federal and state program. The Centers for Medicare & Medicaid Services (CMS) sets federal requirements, while each state chooses how to operate its program within those requirements. That state role matters: income limits, premiums, copayments, covered networks, application portals, and some eligibility details differ across the country.

This page explains what the current official guidance supports and how to start an application. It does not replace a state eligibility decision. If you are unsure whether your child is within the income range, applying is more useful than trying to guess from a national rule.

CHIP at a glance

The word “ongoing” in the deadline field has a specific meaning here. CHIP does not have a single 2026 cohort or a published national application window. HealthCare.gov says Medicaid and CHIP applications can be made any time of year, and CMS directs people to state Medicaid agencies for applications and eligibility questions. A state can have its own processing rules and coverage start rules, but that is different from a program-wide deadline.

What CHIP pays for

CHIP provides comprehensive health insurance benefits for children, but the exact package depends on whether a state operates separate CHIP, Medicaid expansion CHIP, or both. CMS says separate CHIP programs must provide certain benefits, including well-baby and well-child visits, dental care, behavioral-health services, and age-appropriate vaccines. A separate CHIP package can also include physician services, hospital care, laboratory and imaging services, prescriptions, and other services according to the state’s approved benefit design.

Dental coverage is not an optional extra in a separate CHIP program. CMS describes the required dental benefit as coverage needed to prevent disease, promote oral health, restore oral structures to health and function, and treat emergency conditions. States publish the details of their dental package and participating providers, so a parent should check the plan’s provider directory before assuming a particular dentist accepts the coverage.

Behavioral-health coverage is also part of the federal requirements for separate CHIP. The official benefits guidance includes services to prevent, diagnose, and treat a broad range of mental-health and substance-use conditions, with parity requirements governing how limits and cost sharing are applied. The practical details still depend on the state plan, provider network, and medical-necessity rules.

Vaccines and preventive visits are central to the program. A child’s state plan determines how appointments are scheduled and which providers participate. CHIP is not merely emergency-only assistance, and the official benefit design is intended to support routine pediatric care as well as treatment when a child is sick.

If a state operates Medicaid expansion CHIP, the child receives the Medicaid benefit package provided under that state’s Medicaid plan or applicable demonstration. CMS also identifies the Early and Periodic Screening, Diagnostic and Treatment (EPSDT) benefit for children in Medicaid expansion CHIP. This is one reason the same application may lead to Medicaid for one child and separate CHIP for another: the programs are coordinated, but the final coverage category depends on the child’s facts and the state’s design.

Who may qualify

For targeted low-income children, CMS lists several core requirements. The child generally must be under 19, uninsured, a resident of the state, within the state’s CHIP income range, and a U.S. citizen or someone who meets the applicable immigration requirements. “Uninsured” is not simply a family preference. CMS describes the child as ineligible for Medicaid and not covered through a group health plan or other creditable health insurance, subject to the state’s rules and any exceptions.

Income is not one national dollar amount. CHIP financial eligibility is based on MAGI, and each state sets its own income standard within federal parameters. CMS currently describes CHIP eligibility levels for relevant groups ranging from about 170% to 400% of the Federal Poverty Level. That range is a guide to the variation between states, not a promise that every state uses the same threshold or that every family at a particular percentage qualifies.

The application will consider household and financial information under the state’s MAGI method. A family with irregular wages, self-employment income, a recent job change, child support, or other income should report the information the application requests rather than converting it into a rough national estimate. The agency, not this page, makes the eligibility calculation. If the application indicates that a child is eligible for Medicaid instead of CHIP, the family should follow that result; Medicaid and CHIP are intended to be screened together.

Citizenship and immigration rules also require care. CMS says children must be U.S. citizens or meet immigration requirements, and it identifies certain qualified non-citizens, including lawful permanent residents, as examples. States may offer coverage to lawfully present children under particular options, while federal rules can impose a waiting period in states that do not use those options. A parent should not decide that a child is ineligible based only on a general internet statement. Report the status requested by the application and ask the state agency what documentation or rule applies.

CHIP can include additional populations in some states. A separate CHIP may cover targeted low-income pregnant women, and states may use a from-conception-to-end-of-pregnancy option. Those are state-plan choices with their own conditions. This page focuses on children and does not promise that every state offers pregnancy-related CHIP coverage.

States have flexibility in other eligibility details as well. CMS notes that some programs may use rules connected to geography, disability status, or other state-plan provisions. The safest national statement is therefore: an uninsured child under 19 who lives in the state and falls within that state’s income and non-financial rules should be screened for CHIP and Medicaid.

How much does it cost?

There is no single national CHIP premium or copayment amount to enter in an opportunity listing. CMS describes CHIP as coverage for families whose income is too high for Medicaid but too low to afford private or group coverage, and the program is commonly free or low cost. States can structure premiums and cost sharing differently, often using family income and the selected coverage type. Some children have no premium; others may have a monthly premium or modest charges for particular services.

Do not treat a national dollar estimate as an entitlement. A family should read the state approval notice and plan materials for the actual premium, copayment, deductible rules if any, covered services, provider network, and billing instructions. The amount can also differ between Medicaid and separate CHIP, which is another reason to complete the combined screening instead of selecting a program from a chart.

How to apply

The application route is state-based, but there are several practical ways to begin.

1. Find the correct state agency

Start with the CMS CHIP page and its state program information. For direct help, use CMS’s Medicaid and CHIP state contact page. CMS specifically says the state Medicaid agency is the place to apply, check eligibility, check an application’s status, and ask about a Medicaid or CHIP card.

Use the state where the child lives. The federal page is a reliable starting point, but it is not a universal application form and CMS does not make the final determination for an individual child.

2. Choose an online, phone, or other state method

Most states offer an online application, and states may also provide phone, mail, in-person, or partner-assisted routes. HealthCare.gov can screen a household for Medicaid or CHIP and securely send relevant information to the state agency. The Marketplace call center listed by HealthCare.gov is 1-800-318-2596, with TTY support at 1-855-889-4325. A family can use whichever route is workable; choosing a phone or paper process does not by itself make the child ineligible.

3. Prepare the information the application asks for

Have the following information available before starting, while remembering that the state may request additional proof:

• The child’s name, age, address, and household relationship
• The state residence and contact details for the parent or responsible adult
• Household members and the income information requested under the application’s MAGI rules
• Employer, self-employment, benefits, or other income details when applicable
• The child’s current insurance status and any group or employer coverage offer
• Social Security number or other identifying information requested by the application
• Citizenship or immigration information for the child, if the application asks for it

Do not omit a child because you think the household income is too high or because another family member has insurance. The state can assess each child and route the household to the appropriate program. Give current, accurate information and keep copies or confirmation numbers for anything submitted.

4. Respond to follow-up requests

The state agency may ask for verification or clarification. Read every notice and use the response method and due date shown on that notice. If income recently changed, explain the change through the channel the agency provides. If a document is difficult to obtain, contact the state agency before ignoring the request. Community health centers, hospitals, schools, and other qualified organizations may help with enrollment in states that authorize those arrangements.

Some states use presumptive eligibility. CMS explains that authorized providers, Head Start programs, schools, or community organizations may be able to screen an uninsured child and provide temporary access while the full application is processed. This is not available in the same way in every state, so ask the state agency or a participating organization whether that option exists locally.

5. Review the decision and plan information

If the child qualifies, the state will provide the coverage decision, effective date, plan information, and instructions for using the benefit. A managed-care state may require the family to select a plan or primary-care provider. Check that the child’s pediatrician, dentist, pharmacy, specialists, and preferred hospital are in the network before making a selection when the state gives a choice.

If the child is denied CHIP, read the reason and appeal instructions. A denial may mean the child qualifies for Medicaid, has other coverage, exceeds the state’s income standard, lacks a required document, or does not meet another state rule. The notice should explain the next step. Contact the state agency rather than assuming the federal page can correct an individual case.

Coverage after enrollment

Federal guidance now requires states to provide 12 months of continuous eligibility for children under 19 enrolled in Medicaid or CHIP. CMS identifies the effective date of that requirement as January 1, 2024. Continuous eligibility does not eliminate every responsibility: families should report changes when the state requires them, respond to renewal notices, and update an address or phone number so important notices arrive. The approval notice and state plan materials control the child’s exact coverage details.

Renewal is different from a new annual competition. A family does not wait for a national CHIP opening, but it should complete the state’s renewal process when requested. Keep the state agency informed if the household moves to another state, because residency is part of eligibility and the new state may use different limits and plans.

Bottom line

CHIP is an active, year-round route to free or low-cost child health coverage. The current official guidance supports a simple next step: identify the state Medicaid agency, submit the combined Medicaid/CHIP application, provide accurate household and insurance information, and answer follow-up requests promptly. Eligibility, cost, provider networks, and plan details are state-specific, so do not rely on the old income examples or fixed cost estimates that appeared in earlier versions of this page.

For the verified national program information, use Children’s Health Insurance Program (CHIP) on Medicaid.gov. For state-specific application help, use Where Can People Get Help With Medicaid & CHIP?. Those pages are maintained by CMS and direct families to the agency that can make the actual determination.