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Eligibility

The Children's Health Insurance Program (CHIP) serves uninsured children up to age 19 in families with incomes too high to qualify them for Medicaid. States have broad discretion in setting their income eligibility standards, and eligibility varies across states. 

Income Eligibility

46 States and the District of Columbia cover children up to or above 200% of the Federal Poverty Level (FPL), and 24 of these states offer coverage to children in families with income at 250% of the FPL or higher. States may get the CHIP enhanced match for coverage up to 300% of the FPL, which is higher than the Medicaid federal funding matching rate. See information on CHIP Financing.

States that expand coverage above 300% of the FPL get the Medicaid matching rate. States have the option to provide continuous eligibility to children who remain eligible for CHIP.

Waiting Periods in CHIP

A number of states have eliminated or shortened their waiting periods. View a national chart with a snapshot of state policies on CHIP waiting periods.

New Medicaid & CHIP Coverage Options

Lawfully Residing Children and Pregnant Women

Many states have elected the option under CHIPRA to restore Medicaid and/or CHIP coverage to children and pregnant women who are lawfully residing in the United States. See related federal policy guidance (PDF, 188.34 KB) .

Pregnant Women

CHIPRA created an explicit eligibility category for pregnant women to receive coverage through CHIP in certain circumstances. See related federal policy guidance (PDF, 57.71 KB) . Some states have also chosen to provide prenatal care for pregnant women through the CHIP program through other available vehicles.

Children of Public Employees

The Affordable Care Act of 2010provides states the option to extend CHIP eligibility to state employees' children. Before enactment of the Affordable Care Act children of public employees were not eligible for CHIP, regardless of their income. See related federal policy guidance (PDF, 336.41 KB) .