The Children's Health Insurance Program (CHIP) provides free or low-cost health coverage to children in families that earn too much to qualify for Medicaid but cannot afford private insurance. In 2025, income limits range from 190% to 405% of the Federal Poverty Level depending on the state, meaning a family of four earning anywhere from roughly $61,085 to $130,208 per year may qualify. If you are not sure where your family falls, use the free eligibility screener to check in minutes.
What Is CHIP?
CHIP is a joint federal and state program created in 1997 to close the coverage gap between Medicaid and private insurance. Each state runs its own CHIP program, often under a different name, and sets its own income limits within federal guidelines. Some states run CHIP as an extension of Medicaid (called Medicaid expansion CHIP), while others operate a separate CHIP program with its own benefit structure.
Common state CHIP program names include:
- Texas: CHIP
- California: Medi-Cal (Medicaid expansion covers children)
- Florida: Florida KidCare
- New York: Child Health Plus
- Pennsylvania: CHIP
- Illinois: All Kids
Regardless of the name, the core purpose is the same: getting uninsured children covered.
2025 Federal Poverty Level Reference
CHIP income limits are expressed as a percentage of the Federal Poverty Level (FPL). The 2025 HHS poverty guidelines for the 48 contiguous states are:
| Household Size | 100% FPL | 200% FPL | 250% FPL | 300% FPL | 400% FPL |
|---|
| 1 | $15,650 | $31,300 | $39,125 | $46,950 | $62,600 |
| 2 | $21,150 | $42,300 | $52,875 | $63,450 | $84,600 |
| 3 | $26,650 | $53,300 | $66,625 | $79,950 | $106,600 |
| 4 | $32,150 | $64,300 | $80,375 | $96,450 | $128,600 |
| 5 | $37,650 | $75,300 | $94,125 | $112,950 | $150,600 |
| 6 | $43,150 | $86,300 | $107,875 | $129,450 | $172,600 |
Alaska and Hawaii have higher FPL thresholds. Alaska's 100% FPL for a family of four is approximately $40,190, and Hawaii's is approximately $36,967.
CHIP Income Limits by State 2025
The table below shows the upper income limit for CHIP eligibility in each state, expressed as a percentage of the 2025 Federal Poverty Level. These figures reflect the highest income tier at which a child may qualify for either Medicaid or separate CHIP coverage.
| State | Upper Income Limit (% FPL) | Est. Annual Income Limit (Family of 4) |
|---|
| Alabama | 317% | ~$101,916 |
| Alaska | 208% | ~$83,595 (higher FPL base) |
| Arizona | 230% | ~$73,945 |
| Arkansas | 216% | ~$69,444 |
| California | 266% | ~$85,519 |
| Colorado | 265% | ~$85,198 |
| Connecticut | 323% | ~$103,844 |
| Delaware | 217% | ~$69,766 |
| District of Columbia | 324% | ~$104,166 |
| Florida | 215% | ~$69,123 |
| Georgia | 252% | ~$81,018 |
| Hawaii | 313% | ~$115,704 (higher FPL base) |
| Idaho | 190% | ~$61,085 |
| Illinois | 318% | ~$102,237 |
| Indiana | 255% | ~$81,983 |
| Iowa | 307% | ~$98,701 |
| Kansas | 255% | ~$81,983 |
| Kentucky | 218% | ~$70,087 |
| Louisiana | 255% | ~$81,983 |
| Maine | 305% | ~$98,058 |
| Maryland | 322% | ~$103,523 |
| Massachusetts | 305% | ~$98,058 |
| Michigan | 217% | ~$69,766 |
| Minnesota | 288% | ~$92,592 |
| Mississippi | 214% | ~$68,801 |
| Missouri | 305% | ~$98,058 |
| Montana | 266% | ~$85,519 |
| Nebraska | 218% | ~$70,087 |
| Nevada | 205% | ~$65,908 |
| New Hampshire | 323% | ~$103,844 |
| New Jersey | 355% | ~$114,133 |
| New Mexico | 305% | ~$98,058 |
| New York | 405% | ~$130,208 |
| North Carolina | 216% | ~$69,444 |
| North Dakota | 205% | ~$65,908 |
| Ohio | 211% | ~$67,837 |
| Oklahoma | 210% | ~$67,515 |
| Oregon | 305% | ~$98,058 |
| Pennsylvania | 319% | ~$102,559 |
| Rhode Island | 266% | ~$85,519 |
| South Carolina | 213% | ~$68,480 |
| South Dakota | 209% | ~$67,194 |
| Tennessee | 255% | ~$81,983 |
| Texas | 206% | ~$66,229 |
| Utah | 205% | ~$65,908 |
| Vermont | 317% | ~$101,916 |
| Virginia | 205% | ~$65,908 |
| Washington | 317% | ~$101,916 |
| West Virginia | 305% | ~$98,058 |
| Wisconsin | 306% | ~$98,379 |
| Wyoming | 205% | ~$65,908 |
Dollar amounts are approximations based on 2025 FPL guidelines and rounded to the nearest dollar. Your state may apply additional income disregards that could affect the final number.
Who Qualifies for CHIP?
Income is the main factor, but children must also meet several other requirements:
Age: CHIP covers children under age 19 in most states. Some states extend coverage to age 20 or 21.
Citizenship or immigration status: Children must be U.S. citizens, U.S. nationals, or qualified immigrants. Some states cover lawfully residing children regardless of immigration status using state-only funding.
Residency: The child must live in the state where they are applying.
Insurance status: The child must be uninsured, or in some cases, underinsured. Most states require that the child is not currently enrolled in employer-sponsored insurance that meets minimum standards.
Not eligible for Medicaid: CHIP is designed for children whose family income is above the Medicaid threshold but below the CHIP upper limit. If a child qualifies for Medicaid, they will be enrolled there first.
Pregnant women are also covered under CHIP in many states. Check your state's program for details.
What Does CHIP Cover?
CHIP benefits vary by state but federal law sets a minimum floor of required services. Most children enrolled in CHIP receive:
- Routine well-child visits and physicals
- Immunizations and vaccinations
- Doctor visits (sick and preventive)
- Prescriptions and medications
- Emergency room services
- Mental health and behavioral health care
- Dental care (cleanings, exams, basic procedures)
- Vision care (eye exams, glasses in many states)
- Hospital stays (inpatient and outpatient)
- Lab tests and X-rays
- Specialty care referrals
States running a separate CHIP program (not Medicaid expansion) may have different benefit packages, but federal benchmarks require that coverage be at least as comprehensive as typical employer-sponsored plans.
CHIP Costs: Premiums and Copays
CHIP can be free or low-cost depending on your state and income level. Federal rules cap total out-of-pocket costs at 5% of household income per year.
Premiums: Lower-income families often pay no monthly premium. Families with higher incomes within the eligible range may pay a modest premium, typically $20 to $50 per month depending on the state.
Copays: Routine well-child visits and immunizations are free under CHIP. Other services like specialist visits, ER visits, and prescriptions may carry a small copay, usually $3 to $35 per service.
No cost sharing for certain services: Federal law prohibits copays or premiums for Native American and Alaska Native children enrolled in CHIP.
How to Apply for CHIP
Applying for CHIP is straightforward. There is no limited open enrollment period, meaning you can apply any time of year.
Step 1: Check your child's eligibility
Use the free screener at BenefitsUSA to get a quick estimate based on your state, income, and household size before submitting a formal application.
Step 2: Gather your documents
You will typically need:
- Proof of identity for the child (birth certificate or passport)
- Proof of U.S. citizenship or immigration status
- Proof of state residency (utility bill, lease agreement)
- Proof of household income (pay stubs, tax return, employer letter)
- Social Security numbers for the child and applicants
- Current health insurance information if any
Step 3: Choose your application method
You have three main options:
- Online: Apply through your state Medicaid or CHIP agency's website. Most states have an online portal that processes applications quickly.
- Health Insurance Marketplace: Go to healthcare.gov and complete an application. If your child may qualify for CHIP, the Marketplace will automatically forward the application to your state agency.
- By phone: Call the national CHIP helpline at 1-877-543-7669. A specialist can help you complete your application over the phone.
- In person or by mail: Some states allow paper applications at local health department offices or social services agencies.
Step 4: Submit your application
Double-check that all required documents are included. Incomplete applications are a common reason for delays.
Step 5: Await a decision
States are required to process CHIP applications within 45 days (or within 90 days if verification is needed). Many online applications receive decisions much faster.
Step 6: Enroll and select a plan
If approved, you will receive enrollment information. In states with managed care, you may need to select a health plan from a list of participating insurers.
CHIP vs. Medicaid: Key Differences
Both programs cover children, but there are practical differences:
| Factor | Medicaid | CHIP |
|---|
| Income limit | Typically up to 138% to 200% FPL | Typically 200% to 400% FPL |
| Cost to family | Free (no premiums, no copays) | Low-cost (small premiums possible, minimal copays) |
| Benefits | Comprehensive, federally mandated | Comparable to employer plans, state-defined |
| Application | Same application as CHIP | Same application as Medicaid |
| Waiting periods | None | Some states have 3-month waiting periods for employer insurance |
You do not need to know which program your child qualifies for before applying. The single application process screens for both.
Recent Policy Changes (2025-2026)
Continuous enrollment protections: The COVID-era continuous enrollment requirements ended in 2023, and states have been processing renewals since then. If you received a renewal notice and did not respond, your child may have lost coverage. You can reapply at any time.
Medicaid Unwinding: Some children who lost Medicaid coverage during the unwinding process may now qualify for CHIP. If your child was disenrolled from Medicaid, check CHIP eligibility immediately.
Express Lane Eligibility: Several states use data from other programs (like SNAP) to automatically identify and enroll eligible children in CHIP without requiring a separate application. Check whether your state uses this process.
CHIP funding: CHIP funding was reauthorized through 2027, providing stability for state programs through the near term.
States With the Highest CHIP Income Limits
These states have the most generous upper income thresholds, covering families with relatively higher incomes:
| State | Upper Limit |
|---|
| New York | 405% FPL (~$130,208 for family of 4) |
| New Jersey | 355% FPL (~$114,133 for family of 4) |
| District of Columbia | 324% FPL (~$104,166 for family of 4) |
| Connecticut | 323% FPL (~$103,844 for family of 4) |
| New Hampshire | 323% FPL (~$103,844 for family of 4) |
| Pennsylvania | 319% FPL (~$102,559 for family of 4) |
| Illinois | 318% FPL (~$102,237 for family of 4) |
States With the Lower CHIP Income Limits
These states have tighter eligibility thresholds. Children in these states may need to explore other coverage options if their family income exceeds these limits:
| State | Upper Limit |
|---|
| Idaho | 190% FPL (~$61,085 for family of 4) |
| Nevada | 205% FPL (~$65,908 for family of 4) |
| North Dakota | 205% FPL (~$65,908 for family of 4) |
| Utah | 205% FPL (~$65,908 for family of 4) |
| Virginia | 205% FPL (~$65,908 for family of 4) |
| Wyoming | 205% FPL (~$65,908 for family of 4) |
| Texas | 206% FPL (~$66,229 for family of 4) |
If your child does not qualify for CHIP in one of these states, ACA marketplace plans with premium tax credits may be available for families with incomes between 100% and 400% FPL.
Frequently Asked Questions
What is the income limit for CHIP in 2025?
CHIP income limits vary by state. Most states cover children in families earning between 200% and 317% of the Federal Poverty Level. That translates to roughly $64,300 to $101,916 per year for a family of four using 2025 FPL guidelines. New York has the highest limit at 405% FPL (about $130,208 for a family of four), while Idaho has the lowest at 190% FPL (about $61,085 for a family of four).
Does CHIP cover dental and vision?
Federal law requires CHIP to cover dental care as a mandatory benefit. Vision care is also covered in most states, including routine eye exams and eyeglasses. Coverage details vary by state, so check your specific state's CHIP program for a complete list of benefits.
Can I apply for CHIP at any time of year?
Yes. Unlike ACA Marketplace plans, CHIP has no open enrollment period. You can apply any time of year, and if your child qualifies, coverage can begin quickly, sometimes on the same day.
What if my child does not qualify for CHIP?
If your child's family income is above the CHIP limit, you may qualify for ACA Marketplace coverage with premium tax credits. Families with incomes between 100% and 400% FPL (and in some cases above) may be eligible for subsidized coverage. Use the free screener to see all programs your family might qualify for.
Does CHIP have a waiting period?
Some states have a 3-month waiting period for children who had access to employer-sponsored insurance within the past few months. However, exceptions apply in cases of loss of coverage, and many states have eliminated the waiting period entirely. Native American and Alaska Native children are exempt from all waiting periods.
How long does it take to get approved for CHIP?
States are required to process applications within 45 days under normal circumstances. Many online applications are processed much faster, sometimes within days. If the state needs additional documentation to verify immigration status, the timeline extends to 90 days.
Can undocumented children qualify for CHIP?
Undocumented children are not eligible for federal CHIP funding. However, several states including California, New York, and Illinois have used state-only funding to extend coverage to children regardless of immigration status. Check your state's specific program for details.
Is CHIP the same as Medicaid?
No. Medicaid covers lower-income children (and adults) at no cost. CHIP covers children in moderate-income families who earn too much for Medicaid but not enough to afford private coverage. Applications go through the same process and portal, and eligibility is screened for both programs simultaneously.
How do I find my state's CHIP program?
Visit your state's Medicaid agency website, go to healthcare.gov and start an application, or call 1-877-543-7669. You can also use the free eligibility screener on BenefitsUSA to get a quick read on your options before applying.
What happens when my child ages out of CHIP?
When a child turns 19 (or the state's maximum age), they lose CHIP eligibility. Young adults should look into Medicaid (if income qualifies), ACA Marketplace plans with premium subsidies, or employer-sponsored coverage. The loss of CHIP qualifies as a special enrollment period for the ACA Marketplace.
