December 10, 2020
2 minute read

Understanding the Children’s Health Insurance Program

CHIP Medicaid

If you’re searching for low-cost health insurance for your children, see if your family qualifies for the Children’s Health Insurance Program (CHIP). But who is eligible, and how do you apply? Here are the basics on CHIP.

What Does CHIP Mean?1

The acronym CHIP means Children’s Health Insurance Program, which is a federal healthcare program that provides low-cost coverage to children whose families earn too much to qualify for Medicaid. Qualifying for CHIP means you won’t have to buy an Affordable Care Act (ACA) marketplace plan to cover your child or children.

How Is CHIP Different From Medicaid?1

CHIP helps provide coverage to children, specifically, while Medicaid is mainly for families. If your income is too much to qualify for Medicaid, CHIP can step in to offer your children low-cost healthcare coverage options.

Do All States Have CHIP?1,2

Yes, all states have their own version of CHIP, and coverage varies by state. CHIP works closely with your state Medicaid program to determine your specific coverage options. Medicaid and CHIP are both public insurance programs that cover children and are jointly funded by state and federal funds.

What Services Does CHIP Cover?2

CHIP offers comprehensive coverage, regardless of where you live. CHIP coverage includes the following benefits:

  • Routine check-ups
  • Visits to your doctor
  • Emergency services
  • Inpatient and outpatient hospital care
  • Prescriptions
  • Immunizations
  • Dental and vision care
  • Laboratory and X-ray services

Some states may provide additional CHIP benefits.

Who Is Covered Under CHIP?3

In most states, CHIP covers children up to age 19 in families of four with an annual income of $50,000. Coverage eligibility applies to U.S. citizens and certain lawfully present immigrants. Children are eligible even if one or both parents are employed.

Parents, grandparents, or other legal guardians can apply on behalf of children. In some states, teens living alone can apply for themselves.

What Is the Income to Qualify for CHIP?2

The income to qualify for CHIP varies by state, but enrollees will not pay more than 5% of their families’ annual income. Routine doctor and dental visits for “well children” are free of charge under CHIP, but there may be copayments for other services. Your state may also charge a monthly premium for CHIP coverage.

When Is the Enrollment Period for CHIP Coverage?2

You can apply to enroll in CHIP at any time. Unlike Affordable Care Act (ACA) plans enrollment, there is no designated period to enroll. Your child/children will be covered immediately once your state determines eligibility.

How Do I Apply for CHIP?2

Your state program has specific guidelines to determine who qualifies for CHIP. To apply, go through your state agency or call 1-800-318-2596 (TTY: 1-855-889-4325).

If your family doesn’t qualify for CHIP, you can still explore all your coverage options. Get started.

footer logo
facebook logo

© 2023 HealthMarkets Insurance Agency. All rights reserved.

* Medicare Advantage, Medicare Supplemental Insurance, and Part D options can be explored.

We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program to get information on all of your options.

To send a complaint to Medicare, call 1-800-MEDICARE (TTY users should call 1- 877-486-2048), 24 hours a day/7 days a week). If your complaint involves a broker or agent, be sure to include the name of the person when filing your grievance.

Attention: This website is operated by HealthMarkets Insurance Agency, Inc. and is not the Health Insurance Marketplace® website. HealthMarkets Insurance Agency, Inc. is licensed as an insurance agency in all 50 states and DC. Not all agents are licensed to sell all products. Service and product availability varies by state. Sales agents may be compensated based on a consumer’s enrollment in an insurance plan. No obligation to enroll. Agent cannot provide tax or legal advice. Contact your tax or legal professional to discuss details regarding your individual business circumstances. Our quoting tool is provided for your information only. All quotes are estimates and are not final until consumer is enrolled. Medicare has neither reviewed nor endorsed this information.

HealthMarkets Insurance Agency offers the opportunity to enroll in either QHPs or off-Marketplace coverage. Please visit HealthCare.gov for information on the benefits of enrolling in a QHP. Off-Marketplace coverage is not eligible for the cost savings offered for coverage through the Marketplaces.

This information is not a complete description of benefits. Call the Plan’s customer service phone number for more information.

46820-HM-1220

© 2023 HealthMarkets Insurance Agency. All rights reserved.

* Medicare Advantage, Medicare Supplemental Insurance, and Part D options can be explored.

We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program to get information on all of your options.

To send a complaint to Medicare, call 1-800-MEDICARE (TTY users should call 1- 877-486-2048), 24 hours a day/7 days a week). If your complaint involves a broker or agent, be sure to include the name of the person when filing your grievance.

Attention: This website is operated by HealthMarkets Insurance Agency, Inc. and is not the Health Insurance Marketplace® website. HealthMarkets Insurance Agency, Inc. is licensed as an insurance agency in all 50 states and DC. Not all agents are licensed to sell all products. Service and product availability varies by state. Sales agents may be compensated based on a consumer’s enrollment in an insurance plan. No obligation to enroll. Agent cannot provide tax or legal advice. Contact your tax or legal professional to discuss details regarding your individual business circumstances. Our quoting tool is provided for your information only. All quotes are estimates and are not final until consumer is enrolled. Medicare has neither reviewed nor endorsed this information.

HealthMarkets Insurance Agency offers the opportunity to enroll in either QHPs or off-Marketplace coverage. Please visit HealthCare.gov for information on the benefits of enrolling in a QHP. Off-Marketplace coverage is not eligible for the cost savings offered for coverage through the Marketplaces.

This information is not a complete description of benefits. Call the Plan’s customer service phone number for more information.

46820-HM-1220

© 2023 HealthMarkets Insurance Agency. All rights reserved.

* Medicare Advantage, Medicare Supplemental Insurance, and Part D options can be explored.

We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program to get information on all of your options.

To send a complaint to Medicare, call 1-800-MEDICARE (TTY users should call 1- 877-486-2048), 24 hours a day/7 days a week). If your complaint involves a broker or agent, be sure to include the name of the person when filing your grievance.

Attention: This website is operated by HealthMarkets Insurance Agency, Inc. and is not the Health Insurance Marketplace® website. HealthMarkets Insurance Agency, Inc. is licensed as an insurance agency in all 50 states and DC. Not all agents are licensed to sell all products. Service and product availability varies by state. Sales agents may be compensated based on a consumer’s enrollment in an insurance plan. No obligation to enroll. Agent cannot provide tax or legal advice. Contact your tax or legal professional to discuss details regarding your individual business circumstances. Our quoting tool is provided for your information only. All quotes are estimates and are not final until consumer is enrolled. Medicare has neither reviewed nor endorsed this information.

HealthMarkets Insurance Agency offers the opportunity to enroll in either QHPs or off-Marketplace coverage. Please visit HealthCare.gov for information on the benefits of enrolling in a QHP. Off-Marketplace coverage is not eligible for the cost savings offered for coverage through the Marketplaces.

This information is not a complete description of benefits. Call the Plan’s customer service phone number for more information.

46820-HM-1220