Medicaid and the Children's Health Insurance Program

You and your family may qualify for free or low-cost health insurance coverage through Medicaid or the Children's Health Insurance Program (CHIP). These programs provide health coverage to nearly 60 million people across the country including children, pregnant women, parents, adults, seniors, and individuals living with disabilities. To learn more and find information about your individual options available and how to apply for these programs, see Healthcare.gov or InsureKidsNow.gov.

Who Is Eligible For Medicaid?

Eligibility for Medicaid is based on income and other circumstances. Each state sets its own Medicaid eligibility rules, but in general, all states make health coverage available to the following people:

• In general, children in families with incomes up to $44,100 per year (for a family of four) are likely to be eligible for Medicaid coverage. In many states, families with higher incomes can also qualify for CHIP.
• Pregnant women with family incomes up to $19,565 for a family of two but many states provide coverage for women with incomes up to $27,214.
• Parents (income limits vary by state).
• People with disabilities—in nearly all states, Medicaid covers people with incomes up to $1,868; many states go to $10,890 FPL.
• Beginning on January 1, 2014, adults under age 65 with family incomes up to $14,484 will be eligible for Medicaid in every state.

What Does Medicaid Cover?

Medicaid provides coverage for a range of benefits including:

• Doctor visits
• Emergency care
• Hospital care
• Vaccinations
• Prescription drugs
• Vision
• Hearing
• Long-term care
• Preventive care for children

All states offer coverage for these services and many states also provide additional services through their Medicaid programs. Learn more about Medicaid in your state.

The Children's Health Insurance Program (CHIP)

CHIP provides low-cost health insurance coverage for children in families who earn too much income to qualify for Medicaid, but can’t afford private health insurance.

Who Is Eligible for CHIP?

The Children's Health Insurance Program (CHIP) provides free or low-cost health coverage for nearly 8 million children up to age 19. Each state sets its own eligibility rules, but in general, children in families with incomes up to $44,100/year (for a family of four) are likely to be eligible for coverage. In many states, families can have higher incomes and their children can still qualify. Learn more about CHIP in your state.

What Does CHIP Cover?

All states cover routine check-ups, immunizations, hospital care, dental care, and lab and x-ray services for children enrolled in CHIP. Children get free preventive care, but low premiums and other cost sharing may be required for other services. Learn more about CHIP in your state.

Applying for Health Coverage Is Easy and Free

Learn more about coverage that is available in your state. You can also make a free call to 1-877 KIDS NOW (1-877-543-7669) to learn about coverage for your child. When you call our free and confidential hotline, you'll be connected directly to someone from your state who will help you apply. Families will need to complete an application and provide some documents. Depending on the state, you can complete the application through the mail, over the phone, or even online.