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CHIP: What you need to know about the Children's Health Insurance Program

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Health insurance for children is vital to a family’s well being. Not only does health insurance for kids help a child’s health. It can keep a family from falling into debt because of health care costs.
There are multiple options for children’s health care depending on your job, income and where you live. Medicaid offers children’s health insurance for families with low incomes. However, children whose parents make too much to qualify for Medicaid but can’t afford private health insurancemay have another government plan option.

The Children’s Health Insurance Program (CHIP) provides coverage to about 10 million children 18 and under. CHIP is comprehensive health insurance but comes with little to no costs.

CHIP is a federal/state program that has different names depending on the state. There are also state variations in eligibility and coverage, including some states cover pregnant mothers, too.

What does the Children’s Health Insurance Program cover?

CHIP covers similar health care services found in a private insurance plan.

The plans provide coverage for preventive check-ups, physician visits, immunizations, labs, emergencies, mental health, hospitalizations and inpatient services. CHIP also offers dental and vision care, which isn’t usually found in a private health plan.

Income requirements for CHIP

Income requirements vary by state. Your state, household income and number of people in your family affect whether you’re eligible. Many states allow children in families with household incomes up to 200% of the federal poverty level to get CHIP.

What’s 200% of the federal poverty level in 2021? Here’s the difference by household size:

  • 1 person -- $25,520
  • 2 people -- $34,480
  • 3 people -- $43,440
  • 4 people -- $52,400
  • 5 people -- $61,360
  • 6 people -- $70,320

Note: household income eligibility requirements are stricter in some states. The above numbers are a guide. Check with your state to see whether your child qualifies for CHIP.

When can you sign up for CHIP?

You can enroll in CHIP at any time.

There’s no open enrollment period like in employer-sponsored health insurance, Medicare and individual health insurance. Instead, CHIP is similar to Medicaid and allows you to sign up at any time in which you’re eligible.

Finding a CHIP provider

Not all providers accept CHIP.

Call your state’s CHIP department or check the program’s site for the provider directory and see which ones in your area take CHIP. You can also go to the Centers for Medicare and Medicaid Services’ site children’s health care site

If you already have a provider, check with the doctor’s office to see if the practice accepts CHIP.

Medicaid

Similar to CHIP, Medicaid offers comprehensive health insurance for little or no money, depending on household income.

Medicaid is an option for low-income people. Medicaid expanded in 38 states to allow people up to 138% of the federal poverty level to get coverage.

States also often have more relaxed household income requirements for children to enroll in Medicaid. So, even if you, as an adult, don’t qualify for Medicaid, you should still check with your state about Medicaid eligibility for your child.

Finding comprehensive health insurance for children is essential for families. Programs like CHIP and Medicaid offer the benefits of private health insurance but come with a much smaller price tag for you.