The Children's Health Insurance Program (CHIP) covers roughly 7 to 8 million low-income children across the United States, providing free or low-cost health coverage to kids whose families earn too much for Medicaid but can't afford private insurance. In 2026, the program faces a combination of structural changes at the state level, new federal policy shifts from the 2025 reconciliation law, and updated income thresholds that families need to know about.
If your child doesn't have health insurance, or you're not sure what they qualify for, this guide covers current CHIP eligibility rules, income limits by family size, how to apply, and what's changing in 2026.
What Is CHIP and Who Does It Cover?
CHIP is a joint federal-state program authorized under Title XXI of the Social Security Act. Every state, the District of Columbia, and U.S. territories run their own CHIP program within federal guidelines. States can structure their programs as:
- Separate CHIP programs with their own benefits and cost-sharing structures
- CHIP-funded Medicaid expansion (called M-CHIP), where children receive Medicaid benefits through CHIP funding
- Combination programs that blend both approaches
As of 2026, the trend is toward M-CHIP models. Utah announced plans to convert its separate CHIP program to M-CHIP in mid-2026, which would bring the total number of M-CHIP states to approximately 23, up from 18 a decade ago.
CHIP covers children from birth through age 18 (and in some states, up to age 19). Pregnant women may also qualify for CHIP in states that have opted into that coverage option.
CHIP Income Limits for 2026
CHIP eligibility is based on your household income as a percentage of the federal poverty level (FPL). In 2026, the federal poverty level for the contiguous 48 states is:
| Household Size | 2026 Annual FPL |
|---|
| 1 person | $15,960 |
| 2 people | $21,640 |
| 3 people | $27,320 |
| 4 people | $33,000 |
| 5 people | $38,680 |
| 6 people | $44,360 |
| 7 people | $50,040 |
| 8 people | $55,720 |
For each additional person, add approximately $5,680.
States set their own CHIP income limits, expressed as a percentage of the FPL. The federal minimum is 200% FPL, but most states have set higher limits. The national median is around 255% FPL for children. Some states cover children at up to 400% FPL.
Here is what 200%, 255%, and 317% FPL looks like in annual income for a family of four:
| FPL Percentage | Annual Income Limit (Family of 4) |
|---|
| 200% FPL | approximately $66,000 |
| 255% FPL | approximately $84,150 |
| 317% FPL | approximately $104,610 |
| 400% FPL | approximately $132,000 |
These are approximate figures. Your state's actual cutoff may differ slightly depending on how they count income and what deductions or disregards they apply.
CHIP Income Limits by State: Key Examples
Income limits differ substantially by state. Below are examples of CHIP upper income limits for children ages 6 to 18 in selected states, based on data current as of early 2026:
| State | CHIP Upper Income Limit (% FPL) |
|---|
| New York | 400% |
| California | 317% |
| Texas | 200% |
| Florida | 210% |
| Illinois | 317% |
| Pennsylvania | 317% |
| Ohio | 206% |
| Georgia | 247% |
| North Carolina | 210% |
| Michigan | 212% |
| Virginia | 200% |
| Arizona | 200% |
Younger children (under age 6) often qualify at higher income levels in some states. Check your state's Medicaid and CHIP agency directly for the exact limits that apply to your child's age group.
What CHIP Covers
Benefits vary by state but typically include:
- Routine doctor visits and preventive care
- Immunizations
- Dental care (exams, cleanings, fillings)
- Vision care (eye exams and glasses)
- Hospital stays and emergency room visits
- Mental health and behavioral health services
- Prescription drugs
- Laboratory and X-ray services
- Specialty care referrals
Most states charge little or no premium for CHIP. Some charge small co-pays for doctor visits, typically $5 or less. States cannot charge premiums for children in families below 150% FPL.
How to Apply for CHIP in 2026
You can apply for CHIP any time of year. There is no open enrollment period. If your child qualifies, coverage can start quickly, sometimes the same month you apply.
Step 1: Gather your documents.
You will need:
- Proof of identity for each child (birth certificate, Social Security card)
- Proof of citizenship or immigration status (birth certificate, U.S. passport, or naturalization certificate)
- Proof of household income (pay stubs, tax returns, or employer letter)
- Information about any current health insurance
Step 2: Choose how to apply.
You have three options:
- Online: Apply through your state's Medicaid and CHIP portal. You can also apply through HealthCare.gov, which will route you to your state agency if your child appears eligible for CHIP.
- By phone: Call your state's Medicaid or CHIP office directly.
- In person: Visit your local Medicaid or Department of Social Services office.
Step 3: Complete the application.
You will provide information about every member of your household, including income from all sources (wages, self-employment, Social Security, child support, and others).
Step 4: Submit and wait for a determination.
Most states process CHIP applications within 45 days. Some states process them faster. You will receive a written notice of whether your child is approved, denied, or enrolled in Medicaid instead (if their income qualifies them for Medicaid rather than CHIP).
Step 5: Enroll your child in a health plan if required.
In separate CHIP programs, you may need to choose a health plan from a list of options your state provides. In M-CHIP states, your child will be enrolled in Medicaid directly.
Step 6: Renew annually.
CHIP coverage must be renewed each year. Your state will send renewal notices. As of 2026, most states have returned to standard annual renewal procedures following the end of the COVID-era continuous enrollment policy.
Use the Benefits Navigator Screener
Not sure if your child qualifies for CHIP, Medicaid, or another program? The Benefits Navigator screener checks multiple programs at once and gives you a fast estimate based on your state, income, and household size.
Key Policy Changes Affecting CHIP in 2026
Several significant policy changes affect CHIP in 2026 and beyond. Families should be aware of these shifts.
The One Big Beautiful Bill Act (Signed July 4, 2025)
The federal reconciliation law passed in 2025 includes changes that will affect CHIP beginning October 1, 2026:
Immigration eligibility changes: Starting October 1, 2026, many lawfully present immigrants will lose eligibility for CHIP regardless of how long they have lived in the United States. This includes refugees and asylees in some states. States that previously covered these individuals using CHIP funds will no longer receive federal matching funds for that coverage.
Reasonable opportunity period: Before October 1, 2026, states were required to provide CHIP coverage during a "reasonable opportunity period" while immigration status was being verified. After that date, states will no longer be required to provide coverage during this period, and federal matching funds will not be available if states choose to do so.
Six-month eligibility verification: Some provisions require more frequent eligibility checks for certain populations beginning in late 2026.
Projected coverage losses: The Congressional Budget Office projects the 2025 reconciliation law will result in over 10 million more uninsured individuals over the next decade. Children in immigrant families are among those most likely to be affected.
State-Level Structural Changes
Several states are converting their separate CHIP programs to M-CHIP (Medicaid-CHIP) models in 2026. This change generally means:
- Children receive the full set of Medicaid benefits and protections
- Medicaid's more robust appeal rights apply
- Cost-sharing protections are typically stronger
If your state is making this conversion, your child's coverage should continue without interruption, but you may receive a new insurance card or new health plan options.
Federal CHIP Funding Extended Through 2029
The Consolidated Appropriations Act, 2023 extended federal CHIP funding authorization through fiscal year 2029. This means the core funding for the program is secured in the near term, though states still face uncertainty from the 2025 reconciliation law changes.
CHIP vs. Medicaid: What Is the Difference?
Many families qualify for either CHIP or Medicaid for their children, depending on income. Here is how they compare:
| Feature | Medicaid | CHIP |
|---|
| Income limit (typical) | Up to 138% to 200% FPL | Up to 200% to 400% FPL |
| Premiums | None | None or very low |
| Cost-sharing | Very limited | Small co-pays allowed |
| Dental and vision | Covered | Covered (varies by state) |
| Application timing | Any time | Any time |
| Coverage start | Fast (often same month) | Fast (often same month) |
In practice, many states cover children through Medicaid at all income levels up to the state's CHIP limit, using CHIP funds to pay for it (M-CHIP model). In those states, the distinction between "Medicaid" and "CHIP" may not be visible to families.
CHIP vs. Marketplace Insurance
If your child does not qualify for CHIP, they may be eligible for subsidized health insurance through the ACA Marketplace. Here is how the options compare:
| Feature | CHIP | ACA Marketplace |
|---|
| Monthly premium | None or very low | Subsidized, varies |
| Coverage quality | Comprehensive | Varies by plan |
| Income threshold | Up to 200% to 400% FPL | Any income (subsidies phase in) |
| Enrollment timing | Any time | Open enrollment or special period |
| Dental for kids | Usually included | Separate pediatric dental plan |
If your household income is above your state's CHIP limit, marketplace plans with premium tax credits may still be very affordable. Run the Benefits Navigator screener to see both options side by side.
States With the Highest CHIP Enrollment
Some states have significantly higher CHIP enrollment relative to their child population. States with broad eligibility limits and active outreach tend to have higher enrollment rates. New York, California, Texas, and Florida collectively cover a large share of all CHIP-enrolled children in the country due to population size.
According to SmartAsset's 2026 analysis, up to 33% of some state populations receive Medicaid or CHIP benefits, underscoring how central these programs are to American families.
Frequently Asked Questions
Does CHIP cover dental and vision?
Yes. Most state CHIP programs include dental care (exams, cleanings, fillings, and in some states orthodontics) and vision care (eye exams and glasses). This is one of the key advantages of CHIP over many private insurance plans, which often sell dental and vision as separate add-ons.
Can I apply for CHIP if my child already has insurance?
Generally, no. CHIP is designed for children who are uninsured. If your child has employer-sponsored insurance or marketplace insurance, they typically do not qualify for CHIP. Some states have "wrap-around" programs that may help cover costs not paid by private insurance, but standard CHIP enrollment requires the child to be uninsured.
How long does CHIP coverage last?
Once enrolled, CHIP coverage is renewed annually. You will need to verify your child's eligibility each year. Some states use automatic renewals using data from other government sources (like tax records) to simplify this process.
What happens if my income goes up after enrollment?
If your income increases significantly during the year, you should report the change to your state's CHIP agency. If your new income exceeds the CHIP limit, your child may lose eligibility at the next renewal. In most cases, they will not be automatically disenrolled mid-year unless you report the change proactively.
Are undocumented children eligible for CHIP?
Federal CHIP funds cannot be used to cover undocumented children. However, some states use state-only funds to provide health coverage to children regardless of immigration status. California, for example, covers all low-income children through its Medi-Cal program regardless of documentation. Check your state's specific rules.
Can college students stay on CHIP?
CHIP covers children through age 18 in most states (some cover up to 19). After that age, young adults must find other coverage, such as staying on a parent's private insurance plan until age 26, or enrolling in Medicaid or a marketplace plan if income-eligible.
What if my child was recently denied for CHIP?
You have the right to appeal a CHIP denial. Your denial notice will include instructions on how to request a hearing. Common reasons for denial include income above the limit, immigration status, or incomplete documentation. In some cases, submitting additional documentation resolves the issue without a formal appeal.
Does CHIP cover mental health services?
Yes. CHIP programs must cover mental health and substance use disorder services on par with physical health services (mental health parity rules apply). Specific coverage, including therapy and psychiatry, is included in most state CHIP programs.
How do I find my state's CHIP program?
Visit InsureKidsNow.gov or call 1-877-KIDS-NOW (1-877-543-7669). You can also apply through HealthCare.gov, which will route CHIP-eligible children to the appropriate state program. Or use the Benefits Navigator screener to check eligibility and find application links for your state.
What is the income limit for a family of 3 for CHIP?
At 200% FPL, the approximate annual income limit for a family of three is $54,640. At 255% FPL (the national median CHIP limit), it is approximately $69,666. At higher limits like 317% FPL, a family of three could earn up to approximately $86,604. Your exact limit depends on your state.
