CHIP Coverage for Children

Key takeaways

• Who it covers: uninsured children up to age 19; some states also cover pregnant people
• Covers: checkups, vaccines, doctor visits, prescriptions, dental and vision care, and hospital care
• Most useful single change: Apply through your state Medicaid or CHIP agency or HealthCare.gov.
• Commonest mistake: Assuming your income is too high without checking your state's limits.
• See a doctor if any of the signs under "When to get help" below apply to you.

Why it matters

Coverage gives children regular checkups, vaccines and dental care, and many eligible children are not enrolled.

The numbers, in one place

Published figures for CHIP Coverage for Children

Measure	Figure
Who it covers	uninsured children up to age 19; some states also cover pregnant people
Covers	checkups, vaccines, doctor visits, prescriptions, dental and vision care, and hospital care
Cost	low or no cost; any premiums and copays are limited by federal rules
When to apply	any time of year
Insure Kids Now	1-877-543-7669 (1-877-KIDS-NOW)

What helps

• Apply through your state Medicaid or CHIP agency or HealthCare.gov
• Keep up with well-child visits and recommended vaccines
• Use the dental coverage, which is included for children in CHIP
• Respond to renewal notices on time to keep coverage

What to avoid

• Assuming your income is too high without checking your state's limits
• Skipping well-child checkups because your child seems healthy
• Missing renewal deadlines because your address changed

In depth

The Children's Health Insurance Program was created to cover children in working families whose income is above Medicaid limits but too low to make private insurance affordable. It is funded jointly by the federal government and the states. Some states run CHIP as part of Medicaid, some run it as a separate program, and some use a combination, which is why CHIP goes by many different names around the country.

CHIP is designed around what children need most: regular well-child visits, vaccines, dental and vision care, and treatment when they are sick or injured. Preventive care matters especially in childhood because growth, development, hearing, vision and teeth change quickly, and problems found early are often easier to manage. Children enrolled in Medicaid-based programs also get a broad benefit that requires states to cover medically necessary screening, diagnosis and treatment.

Federal rules keep costs low. Any premiums, enrollment fees and copays a family pays are capped at a small share of family income, and well-baby, well-child and preventive services, including vaccines, are generally free. Since 2024, children in Medicaid and CHIP keep coverage for a full 12 months once enrolled, even if family income changes during that year, which helps avoid gaps in care.

Signs and symptoms

• Your child has no health insurance, or coverage through work costs too much for your family
• You have recently lost a job or job-based coverage
• Your child has missed well-child visits or vaccines because of cost
• Your child has not seen a dentist in the past year
• A new baby has joined the family

Causes and risk factors

• Family income and size, measured against your state's limits
• Your child's age, since CHIP covers children up to 19
• Whether your child already has other health insurance
• Your state's choices about how to run CHIP and whom it covers
• Immigration status, which affects eligibility for some children

How it is checked

You can check whether your children qualify by applying through HealthCare.gov or your state Medicaid or CHIP agency, or by calling Insure Kids Now. One application usually checks for Medicaid, CHIP and Marketplace coverage for the whole household at the same time. You will need information about income and household members, and the state will send a notice explaining which program, if any, each child qualifies for.

Children in the same family can qualify for different programs. A younger child may qualify for Medicaid while an older sibling qualifies for CHIP, or a child may qualify while a parent does not. Read the notice for each family member separately, and ask the agency to explain if anything is unclear.

Related topics

• What the Guidance Really Says About Open and Special Enrollment (Health Insurance and Costs)
• Sexual Health Services: What Published Guidance Supports (Sexual Health)
• What the Guidance Really Says About Benefits and Financial Support (Long-Term Conditions)
• The Evidence on Travel Insurance and Healthcare Abroad, Without the Hype (Travel Health)

Where to go next

• CHIP Coverage for Children: What to Do, in Order
• CHIP Coverage for Children: Separating Myth From Guidance
• Medicare and Medicaid: The Complete Guide
• Medicare Wellness Visits: What the Evidence Actually Says
• What the Guidance Really Says About Dual Eligibility

When to get help

Call your child's doctor for fever in a baby younger than 3 months, signs of dehydration or illness that is getting worse. Call 911 if a child has trouble breathing, is unresponsive or has a seizure.

Where this comes from

• Medicaid.gov — Children's Health Insurance Program (CHIP)
• HealthCare.gov — Medicaid & CHIP coverage

How this page was put together

Every figure, recommendation and warning above is taken from the guidance named in Where this comes from. Nothing on this page is inferred, summarized or generalized beyond what those bodies publish: where they give a number, it is their number, and where they are silent, so are we. Pages are rebuilt whenever the underlying record changes. Sign-off by a named clinician, where it has happened, is shown at the top of the page along with the date.

Medical disclaimer

This article is general information, not medical advice. It cannot account for your own history, medication or circumstances. Always speak to your doctor, pharmacist or another qualified health professional before making changes that affect your treatment, and never delay seeking medical advice because of something you have read here. In an emergency, call 911.