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Health care

Children's Health Insurance Program (CHIP)

If your children need health coverage, they may be eligible for the Children's Health Insurance Program (CHIP).

CHIP 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.

See if your children qualify and apply for CHIP

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 to your state agency for Medicaid coverage, you will also find out if your children qualify for CHIP. If they qualify, you won't have to buy an insurance plan to cover them.

Two ways to apply for CHIP:

• Call 1-800-318-2596 (TTY: 1-855-889-4325).

• Fill out an application through the Health Insurance Marketplace. If it looks like anyone in your household qualifies for Medicaid or CHIP, the federal government will send your information to your state agency—and they will contact you about enrollment. When you submit your Marketplace application, you will also find out if you qualify for an individual insurance plan with savings based on your income instead.

Apply any time

You can apply for and enroll in Medicaid or CHIP any time of year. There is no limited enrollment period for either Medicaid or CHIP. If you qualify, your coverage can begin immediately.

What CHIP covers

CHIP benefits are different in each state—but all states provide comprehensive coverage, including:

• Routine check-ups

• Immunizations

• Doctor visits

• Prescriptions

• Dental and vision care

• Inpatient and outpatient hospital care

• Laboratory and X-ray services

• Emergency services

Some states may provide more CHIP benefits. Check with your state for information about covered services.

What CHIP costs

Routine "well child" doctor and dental visits are free under CHIP. But there may be copayments for other services. Some states charge a monthly premium for CHIP coverage. The costs are different in each state, but you won’t have to pay more than 5% of your family's income for the year.

What if my children are eligible for CHIP, but I would rather buy a Marketplace insurance plan?

If your children are eligible for CHIP, they won't be eligible for any savings on Marketplace insurance. CHIP coverage will probably be more affordable. Remember, you and other family members may be eligible for savings on Marketplace insurance coverage.

If my children can get CHIP but I don't qualify for Medicaid, how can I get insured?

You may be able to get an insurance plan through the Marketplace, with savings based on your income.

How do I get started?

To get started, create an account here https://www.healthcare.gov/create-account—or if you already have an account log in here https://www.healthcare.gov/login. If it looks like anyone in your household qualifies for Medicaid or CHIP, the federal government will send your information to your state agency—and they will contact you about enrollment. When you submit your Marketplace application, you will also find out if you qualify for an individual insurance plan with savings based on your income instead.

In Texas, the Children's Health Insurance Program (CHIP) provides low-cost health coverage to children from families with incomes too high to qualify for Medicaid but who cannot afford private insurance. CHIP covers a range of services including routine check-ups, immunizations, doctor visits, prescriptions, dental and vision care, hospital care, lab and X-ray services, and emergency services. Costs for CHIP vary, with routine visits typically free, but there may be copayments for other services and a possible monthly premium that won't exceed 5% of the family's annual income. Pregnant women may also be covered by CHIP in Texas. Eligibility for CHIP is determined by the state, and applications can be submitted at any time during the year through the Health Insurance Marketplace or by calling 1-800-318-2596. If children qualify for CHIP, they are not eligible for Marketplace insurance savings. Adults who do not qualify for Medicaid may still obtain insurance through the Marketplace, potentially with income-based savings. To apply or learn more, individuals can create or log into an account at healthcare.gov.


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