How to Apply for CHIP: What You Need to Know Before You Start

What CHIP Covers and Who Can Join

CHIP covers children whose family income is too high for Medicaid but too low to afford private insurance. The income limit varies by state — some states cover families earning up to 200% of the federal poverty line, others go higher. Your state's CHIP program will have a specific income threshold posted on its website, usually under the state health department or Medicaid agency.

CHIP pays for doctor visits, hospital care, prescriptions, dental and vision care, and mental health services. It does not cover adults, and it does not cover children whose parents can get affordable coverage through an employer. If your child is already on Medicaid, you do not need to move them to CHIP unless your state has a waiting list for CHIP and your child is on it.

Each state runs its own CHIP program under different names — some call it CHIP, others use names like PeachCare, BadgerCare, or Healthy Families. The application process and income rules are specific to your state, so you will need to find your state's program first.

Key Takeaways

• CHIP income limits are set by your state, and you can find your state's specific threshold on your state health department website or by calling 211.
• You will need proof of income (recent pay stubs, tax returns, or a letter from your employer), proof of citizenship or immigration status, and your child's Social Security number or tax ID.
• Most states let you start the application online, by mail, or in person at your local health department office.
• Processing usually takes two to four weeks, though some states have waiting lists when funding runs low.
• If your income changes during the year, you must report it to keep your child's coverage active.

Finding Your State's CHIP Program and Income Limit

Start by visiting your state's Medicaid or health department website. Search for "CHIP" or the program's state-specific name. The program page will list the current income limit for your household size — this is the number you need to know before you do anything else.

If you cannot find it online, call 211 (a free referral line available in all states) and ask for your state's CHIP program. They will tell you the income limit, whether the program is currently open to new members, and whether there is a waiting list. Some states close CHIP to new members when funding runs low and reopen it later in the year.

Write down your state's program name, phone number, and website. You will need these to submit your application and to check your status later.

Gathering Documents Before You Apply

Have these documents ready before you start the application:

• Proof of income for the past 30 days (pay stubs, self-employment records, unemployment statements, or a letter from your employer stating your salary)
• Most recent tax return if you are self-employed
• Proof of citizenship or immigration status for each child (birth certificate, passport, or state ID)
• Social Security number or Individual Taxpayer Identification Number (ITIN) for each child
• Proof of residency in your state (utility bill, lease, or mortgage statement with your name and current address)

If your income varies month to month, gather the last three months of pay stubs so the program can average your income. If you are unemployed or receive benefits, bring documentation from the agency providing those benefits.

If you do not have a Social Security number for your child, you can still apply — the program will help you understand your options. Some states allow you to apply with an ITIN instead.

Starting Your Application

Most states offer three ways to apply: online through the state website, by mail, or in person at your local health department office. Online is usually fastest — you can submit it immediately and track your status.

Go to your state's CHIP website and look for a button that says "Apply" or "Start Your Application." You will enter your household size, income, and the children you want to cover. Have your documents nearby so you can enter the information accurately.

If you apply online, you will usually get a confirmation number and a date when you can expect a decision. Write this down. Some states ask you to upload documents (photos of your pay stubs and proof of citizenship) right away; others mail you a request for documents after you submit the form.

If you prefer to apply by mail or in person, call your state's CHIP program to request an application form. Mail applications take longer — usually three to four weeks — because the program has to receive it, process it, and request any missing documents by mail.

What Happens After You Submit

After you submit your application, the program will review your income to see if it falls within the CHIP range. This usually takes two to four weeks. During this time, you may receive a letter asking for more information or documents — respond as quickly as you can, because delays in sending documents can delay your decision.

If your income is within the limit, you will receive an approval letter with your child's member ID number and coverage start date. Coverage usually begins the first day of the month after approval, though some states backdate it to the first day of the month you applied.

If your income is above the limit, you will receive a denial letter. This letter will explain why and tell you whether you can appeal. Some states allow you to appeal if you believe the program made an error in calculating your income.

If your state has a waiting list, you will receive a letter saying your application is on the list. The program will contact you when funding becomes available and will ask you to confirm that your information is still correct.

Keeping Your Child's Coverage Active

Once your child is covered, you must report any changes in income, household size, or address within 30 days. If you do not report changes, the program may terminate coverage without warning.

Most states send a renewal notice once a year asking you to confirm your income and household information. You must respond by the deadline or coverage will end. If your income has changed, report it on the renewal form — do not wait for the program to ask.

If your income increases above your state's CHIP limit, your child may be moved to Medicaid instead of losing coverage entirely. Ask your state's program what happens in your situation.

What to Do If Your Application Is Denied or Delayed

If you are denied, the letter will explain the reason — usually that your income is above the limit or that you did not provide required documents. Read the letter carefully and look for an appeal deadline, usually 30 days from the date on the letter.

If you believe the program made an error, you can appeal. Call your state's CHIP program and ask how to file an appeal. You will need to explain why you think the decision was wrong and provide any new information or documents that support your case.

If your application is taking longer than four weeks, call the program and ask for a status update. Provide your confirmation number or the phone number you used to apply. If documents are missing, ask exactly which ones and whether you can submit them by email or in person to speed things up.

Frequently Asked Questions

Can I apply if my child already has Medicaid?

Your child can be on both Medicaid and CHIP, but most states will not move a child from Medicaid to CHIP. If your income has changed and your child no longer qualifies for Medicaid, the program will usually move them to CHIP automatically. Contact your state's Medicaid office to ask whether your child should stay on Medicaid or move to CHIP.

What if I do not have a Social Security number for my child?

You can still apply. Some states let you use an ITIN or a state ID number instead. Call your state's CHIP program before you apply and ask what documents they accept. If your child does not have any ID, ask whether you can apply and get a number assigned by the program.

Do I have to pay anything for CHIP coverage?

CHIP is free or very low-cost depending on your state. Some states charge a small monthly premium (usually $5 to $20 per child) or a copay when you visit the doctor. Your approval letter will tell you whether there are any costs. If cost is a barrier, ask your state's program whether you can get a waiver or reduction.

What if my income changes after I am approved?

You must report income changes within 30 days. If your income increases above the CHIP limit, your child may move to Medicaid or lose coverage. If your income decreases, you may get a refund of any premiums you paid. Call your state's program to report the change — do not wait for the renewal notice.

How long does coverage last once I am approved?

CHIP coverage usually lasts for 12 months. Your state will send you a renewal notice before coverage ends, asking you to confirm your income and household information. If you respond by the deadline and your income is still within the limit, coverage will continue for another 12 months.