Texas CHIP (Children's Health Insurance Program) provides low-cost health coverage to children in families who earn too much to qualify for Medicaid but cannot afford private insurance. In 2026, CHIP covers children through age 18 in households earning up to approximately 206% of the federal poverty level (FPL), which works out to about $5,664 per month for a family of four. If your child does not currently have health coverage, CHIP may be an option worth checking even if you think your income is too high.
What Is Texas CHIP?
CHIP is a joint federal-state program. In Texas, it is administered by the Health and Human Services Commission (HHSC) and delivered through managed care health plans. Children who apply first go through a Medicaid check. If they do not qualify for Medicaid (which has lower income limits), the state then checks CHIP eligibility. The two programs work together so eligible children do not fall through the gaps.
Texas CHIP covers routine checkups, sick visits, prescriptions, dental, vision, mental health services, and emergency care. Most families pay low premiums and small copayments, and some pay nothing at all.
Who Qualifies for Texas CHIP in 2026?
To qualify, a child must meet all of the following:
- Age: Under 19 years old
- Residency: Live in Texas
- Citizenship/immigration status: U.S. citizen, U.S. national, or qualifying immigration status
- No access to affordable employer coverage: Children with access to employer-sponsored coverage that meets CHIP standards generally do not qualify
- Income: Family income must be above the Children's Medicaid limit and at or below the CHIP income limit (approximately 206% FPL)
Children who are currently enrolled in Medicare, Texas Medicaid, or have other comprehensive health coverage are typically not eligible for CHIP.
Texas CHIP Income Limits 2026
CHIP and Children's Medicaid work on a sliding scale. Children whose family income falls below the Medicaid threshold qualify for Medicaid, which has no premiums. Children above that threshold but still within the CHIP ceiling qualify for CHIP.
Children's Medicaid Income Limits (Upper Edge of Free Coverage)
Texas uses age-tiered Medicaid limits for children:
| Child's Age | Medicaid Income Limit (Monthly, Family of 4) | FPL |
|---|
| Under 1 | approximately $5,305/month | approximately 198% FPL |
| Ages 1 to 5 | approximately $1,942/month | approximately 133% FPL |
| Ages 6 to 18 | approximately $3,697/month | approximately 138% FPL |
CHIP Income Limits by Household Size (2026)
Children who do not qualify for Medicaid may still qualify for CHIP if monthly household income is at or below these amounts:
| Household Size | Monthly Income Limit | Annual Income Limit |
|---|
| 1 person | $2,739 | $32,868 |
| 2 people | $3,714 | $44,568 |
| 3 people | $4,690 | $56,280 |
| 4 people | $5,664 | $67,968 |
| 5 people | $6,639 | $79,668 |
| 6 people | $7,615 | $91,380 |
| 7 people | $8,590 | $103,080 |
| 8 people | $9,564 | $114,768 |
| Each additional | +$974/month | +$11,688/year |
These limits reflect approximately 206% of the 2026 federal poverty level. Gross income is used in the calculation, and Texas applies MAGI (Modified Adjusted Gross Income) rules for CHIP, which means most standard deductions are not subtracted before comparing to the limit.
If you are unsure whether your family qualifies, use our free benefits screener to check in a few minutes.
CHIP Perinatal: Coverage for Pregnant Women
Texas also offers CHIP Perinatal, which covers the unborn child of a pregnant woman who does not qualify for Medicaid due to immigration status or income. The income limit for CHIP Perinatal is approximately 202% of FPL. Coverage includes prenatal care and two doctor visits within 60 days after delivery.
Families using CHIP Perinatal pay no enrollment fees and no copayments.
What Does Texas CHIP Cover?
Texas CHIP provides comprehensive health coverage for children. Covered services include:
Medical care:
- Well-child checkups and preventive care
- Sick visits and specialist referrals
- Emergency room visits and hospitalization
- Mental health and substance use treatment
- Lab work, X-rays, and diagnostic imaging
- Medical equipment and supplies
Prescription drugs:
- Wide range of covered medications
- Low copayments based on income level
Dental care:
- Routine cleanings and exams
- X-rays, fillings, and extractions
- Orthodontia in some cases
Vision care:
- Annual eye exams
- Prescription eyeglasses (up to $150 toward frames and lenses through some plans)
Other services:
- Therapy services (speech, occupational, physical)
- Family planning services
- Hearing services
How Much Does Texas CHIP Cost?
CHIP is not free for most families, but costs are kept low. The cost structure is based on income level.
Enrollment Fees
Families pay an annual enrollment fee of $50 or less for all children in the household combined. Families with income below a certain threshold pay no enrollment fee at all. Most families pay $35 or less per year.
Enrollment fees do not apply to:
- Families at or below 150% FPL
- Native American and Alaska Native children
- Children receiving CHIP Perinatal services
Copayments
Copayments apply to some services:
| Income Level | Doctor Visit Copay | Prescription Copay | ER Copay |
|---|
| Lower income (below 151% FPL) | $3 to $5 | $3 to $5 | $20 |
| Higher income (151% FPL and above) | $20 to $35 | $20 to $35 | $35 |
There is no copayment for preventive care or well-child visits. Native American and Alaska Native children also pay no copayments.
How to Apply for Texas CHIP in 2026
Applications for CHIP are handled through the same portal as Medicaid and other Texas benefits. Here are your options:
Option 1: Apply Online (Recommended)
- Go to YourTexasBenefits.com
- Create a free account or log into an existing one
- Select "Apply for Benefits" and choose health coverage
- Answer questions about your household size, income, and children's ages
- Upload or submit supporting documents (see below)
- Submit your application
The online application typically takes 30 to 45 minutes to complete. You can save your progress and return later if needed.
Option 2: Apply by Phone
Call 2-1-1, select your language, and press 2 to be connected to a CHIP/Medicaid representative. Phone applications are available during regular business hours.
Option 3: Apply in Person
Visit your local Texas Health and Human Services office. Use the office finder at hhs.texas.gov or call 1-800-252-8263 to locate the nearest office.
Option 4: Apply by Mail or Fax
Download a paper application from YourTexasBenefits.com, complete it, and mail or fax it to HHSC. Processing by mail takes longer than online or phone applications.
Documents Needed to Apply
Gather these before you start your application to avoid delays:
- Proof of identity for each child (birth certificate, school ID, or similar)
- Proof of Texas residency (utility bill, lease agreement, or school records)
- Social Security numbers for all household members applying
- Proof of income (recent pay stubs, W-2, or tax return if self-employed)
- Citizenship or immigration documents if applicable
- Current health insurance information if your family has any existing coverage
You do not need to have all documents ready to submit your application. You can submit first and provide supporting documents within a set window.
After You Apply
Processing time for CHIP applications is typically up to 45 days. For children, the state is required to process applications within this window. If approved, you will receive a CHIP packet explaining your health plan options and coverage start date.
Texas CHIP is delivered through managed care organizations. After approval, you choose a health plan from the available options in your area. Plans available in Texas include providers like Blue Cross and Blue Shield of Texas, Superior HealthPlan, Texas Children's Health Plan, UnitedHealthcare Community Plan, and others depending on your region.
Once enrolled, coverage renews annually. The state will send a renewal notice before your child's coverage expires. Respond promptly to renewal requests to avoid a gap in coverage.
Texas CHIP vs. Children's Medicaid
Both programs cover children, but there are key differences:
| Feature | Children's Medicaid (STAR) | Texas CHIP |
|---|
| Income limit | Varies by age (133% to 198% FPL) | Up to 206% FPL |
| Monthly premium | None | None |
| Annual enrollment fee | None | Up to $50/year |
| Copayments | None | $3 to $35 depending on income |
| Dental coverage | Yes | Yes |
| Vision coverage | Yes | Yes |
Children who qualify for Medicaid are enrolled in Medicaid automatically during the application process. CHIP is the next tier for families who earn slightly more.
What If My Child Doesn't Qualify for CHIP?
If your family income exceeds the CHIP limit, your child may still qualify for subsidized health coverage through the ACA Marketplace at healthcare.gov. Premium tax credits are available for families with income between 100% and 400% FPL (and beyond in some cases). Texas uses the federal marketplace since the state does not run its own exchange.
You can also use our benefits screener to check all programs at once, including CHIP, Medicaid, ACA subsidies, and more.
Renewing Your Texas CHIP Coverage
CHIP coverage lasts for 12 months. Each year, HHSC will send a renewal form before your child's coverage ends. You can renew:
- Online at YourTexasBenefits.com
- By phone by calling 2-1-1
- By returning the mailed renewal form
If your family's income or household size has changed, update your information during renewal. Changes mid-year can also be reported by contacting HHSC directly.
Contact Information
- YourTexasBenefits.com: Main application and renewal portal
- HHSC Phone: 1-800-252-8263
- 2-1-1 Texas: Dial 2-1-1 for local assistance and CHIP help
- InsureKidsNow.gov: Federal resource for CHIP information
For a full overview of Texas benefits programs, visit our Texas benefits guide.
Frequently Asked Questions
How do I know if my child qualifies for CHIP or Medicaid in Texas?
When you apply through YourTexasBenefits.com, the state automatically checks both programs. If your child qualifies for Medicaid (which is free), they will be enrolled there first. If income is above the Medicaid limit but below the CHIP limit, they qualify for CHIP. You do not need to apply separately for each program.
What is the income limit for Texas CHIP for a family of 4 in 2026?
For a family of four, the CHIP income limit is approximately $5,664 per month or about $67,968 per year. This reflects approximately 206% of the federal poverty level.
Does Texas CHIP cover dental and vision?
Yes. Texas CHIP covers routine dental care including cleanings, X-rays, and fillings. Vision coverage includes annual eye exams and a benefit toward prescription eyewear.
How long does it take to get approved for CHIP in Texas?
The state has up to 45 days to process a CHIP or Medicaid application for children. In many cases, processing is faster. Once approved, your child's health plan information will arrive by mail.
Can undocumented children get CHIP in Texas?
Standard CHIP requires U.S. citizenship or qualifying immigration status. However, CHIP Perinatal covers the unborn child of a pregnant woman regardless of the mother's immigration status. Some local programs may also provide limited health services to undocumented children. Contact 2-1-1 for guidance specific to your situation.
What happens if my income goes up during the year?
If your household income increases mid-year, report the change to HHSC through YourTexasBenefits.com or by calling 1-800-252-8263. Your child's eligibility will be reassessed. If income rises above the CHIP limit, you can explore ACA Marketplace plans, which may offer subsidized coverage for your family.
Is there a waiting period for CHIP in Texas?
Texas does not impose a waiting period for CHIP enrollment. Once your application is approved, coverage begins without a delay period. This is important because some states require a waiting period before CHIP coverage starts.
Can I apply for CHIP any time of year?
Yes. CHIP does not have open enrollment periods. You can apply at any time during the year. Coverage begins once your application is approved and you select a health plan.
What if my child already has insurance but it's too expensive?
CHIP requires that children do not have access to affordable employer-sponsored coverage that meets CHIP standards. If the employer plan costs more than a certain percentage of household income, your child may still qualify for CHIP. An HHSC eligibility worker can assess your specific situation.
How do I renew my child's CHIP coverage?
CHIP coverage renews every 12 months. HHSC will send you a renewal packet before your coverage ends. You can renew online at YourTexasBenefits.com, by phone at 2-1-1, or by returning the renewal form by mail. Respond promptly to avoid a gap in your child's coverage.
