The Children’s Health Insurance Program (CHIP) provides low-cost health coverage to children in families who earn too much to qualify for Medicaid but can’t afford private insurance. In most states, CHIP also covers pregnant women. CHIP is jointly funded by the federal government and states, and eligibility rules vary by state.
CHIP covers a comprehensive set of services including:
Unlike Marketplace plans, CHIP accepts applications year-round — there is no Open Enrollment Period. If your child qualifies, they can be enrolled at any time.
CHIP eligibility is based on household income as a percentage of the Federal Poverty Level. The income threshold varies by state but generally covers families earning up to 200%–300% FPL. Premiums, if any, are very low. Some states charge no premium at all.
No — CHIP and Marketplace plans are separate. If your child qualifies for CHIP, enrolling them in a Marketplace plan instead does not make them CHIP-ineligible, but you would pay more for less comprehensive coverage. CHIP is almost always the better option for eligible children. You can check eligibility at HealthCare.gov or your state’s Medicaid/CHIP office.
Losing CHIP coverage is a qualifying life event that opens a 60-day Special Enrollment Period for Marketplace coverage. If your income rises above CHIP’s eligibility threshold, you have 60 days to enroll in a Marketplace plan. Your child may also qualify for a Premium Tax Credit on a Marketplace plan depending on your household income.
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