CHIP Eligibility in 2026: The Kids' Coverage Band Between Medicaid and Marketplace

Published July 14, 2026

Here is the number most parents get wrong: the income line for children's coverage sits far higher than the one for adults. A family can earn too much for Medicaid, look at a marketplace plan, decide it is unaffordable, and walk away assuming their kids have no options - when in most states those same kids qualify for the Children's Health Insurance Program (CHIP). The upper limit runs to a median of about 255% of the federal poverty level, and as high as 400% in New York. CHIP is the coverage band nobody tells you about, hiding behind fifty different state brand names.

The short version: CHIP covers kids in the income zone above Medicaid and below "I can comfortably buy a marketplace plan." It is MAGI-based with no asset test, costs little or nothing, and once a child is enrolled they keep coverage for a full 12 months even if your income rises.

What CHIP actually is

CHIP is a joint federal-state program that covers children in families who earn too much for their state's children's Medicaid threshold but not enough to easily afford private insurance. It was built to close exactly that gap. Every state runs one, and every state covers kids at higher income levels than adults - a point our state-by-state Medicaid income limits guide lays out in detail.

The practical effect: the eligibility fork most families think is binary - "Medicaid or a marketplace plan" - is actually three lanes for children. Medicaid at the bottom, CHIP in the middle, and subsidized marketplace coverage above that. If you have already worked through our Medicaid vs. marketplace breakdown for the adults in your household, CHIP is the piece that changes the answer for the kids.

The income line: how high it really goes

There is no single national CHIP cutoff. Each state sets its own upper limit, and the spread is enormous:

Highest: New York covers children up to 400% of the federal poverty level - roughly $128,000 for a family of four in 2026 terms.
Lowest: North Dakota sits near the federal floor at about 170% FPL.
Typical: The median state upper limit is about 255% FPL, and at least 19 states cover kids at or above 300% FPL.

That is why the "we make too much" instinct is so often wrong. A household at 260% FPL is over the line for adult Medicaid in every state, but under the CHIP line in more than half of them. Source: KFF, Medicaid/CHIP upper-income eligibility limits for children. To see where your own state's line falls, the fastest check is to run your household numbers through the calculator.

Why your state's program has a strange name

Search for "CHIP" in your state and you often will not find the word "CHIP" at all. States brand the program, which is why so many parents never realize they are looking at it. A partial decoder:

KanCare - Kansas (combined Medicaid + CHIP)
PeachCare for Kids - Georgia
Dr. Dynasaur - Vermont
ALL Kids - Alabama (covers children up to 317% FPL)
Child Health Plus - New York
Denali KidCare - Alaska
Florida KidCare - Florida
Hoosier Healthwise - Indiana
HUSKY B - Connecticut
ARKids First - Arkansas

If your search-console-famous state runs a combined program - Kansas's KanCare is the clearest example - the same application covers both Medicaid and CHIP, and the state sorts your child into whichever one fits your income. You do not choose between them.

Separate CHIP vs. Medicaid-expansion CHIP - and why it matters

States run CHIP in one of three structures, and the structure quietly changes what your child is entitled to:

Medicaid-expansion CHIP: CHIP is folded into Medicaid. Kids get the full Medicaid benefit package, including the comprehensive EPSDT benefit for children, an entitlement to coverage, and almost no cost-sharing.
Separate CHIP: The state runs CHIP as its own program. This gives states room to charge modest premiums and copays - and, importantly, children are not legally entitled to coverage, so a separate-CHIP state can impose enrollment caps or waiting lists if funding tightens.
Combination: Most states do both, often covering younger or lower-income kids through Medicaid expansion and older or higher-income kids through separate CHIP.

For day-to-day purposes the benefits are broadly comprehensive under all three. The distinction matters most at the edges: whether you might pay a small premium, and whether coverage is a guarantee or subject to a cap. Source: Medicaid.gov, CHIP eligibility.

What CHIP costs

For most families, very little. Many states charge no premium at all; others charge modest monthly premiums or a small enrollment fee on a sliding scale tied to income. The hard ceiling is federal: total out-of-pocket costs - premiums plus all cost-sharing combined - cannot exceed 5% of your family's annual income. Copays for a doctor visit are typically a few dollars. Compared with a marketplace plan's premium and deductible, CHIP is almost always the cheaper path for a child when the child qualifies.

The 2026 rules that actually matter

Three current rules change how families should think about CHIP this year:

1. Once your kid is in, they stay in for 12 months

Since January 1, 2024, federal law requires every state to provide 12 months of continuous eligibility for children under 19 in both Medicaid and CHIP. A mid-year raise, a seasonal bonus, or a new job generally will not knock a child off coverage until the annual renewal. This is a meaningfully stronger protection than adults get - our guide to the 2026 shift to six-month adult renewals shows the contrast: adults now re-verify twice a year, while kids are locked in for the full twelve.

2. Work requirements do not touch children

The new 2026 Medicaid work requirements apply only to certain adults in the expansion population. Children and pregnant enrollees are explicitly exempt, and CHIP is outside the work-requirement rules entirely. A parent losing coverage over paperwork does not put their child's CHIP at risk.

3. Funding is secure through 2029

CHIP is federally funded through September 30, 2029 under the 2023 Consolidated Appropriations Act. There is no CHIP funding cliff in 2026 - a genuine difference from the enhanced ACA subsidies, which are on a separate and far shakier timeline. Source: InsureKidsNow.gov.

How to tell if your child qualifies

Work the three lanes in order:

Estimate your MAGI. CHIP uses Modified Adjusted Gross Income - the same income figure the ACA marketplace uses - with no asset test. Your home, car, and savings are irrelevant.
Check children's Medicaid first. If your income is low enough, your kids land in Medicaid, which is free and most comprehensive.
Then check CHIP. If you are over the Medicaid line but under your state's CHIP limit - anywhere up to that 255% median or higher - your kids likely qualify for CHIP even when the adults are shopping the marketplace.

Because the lines differ by state and household size, the reliable move is to check your numbers against your state's thresholds rather than assume. Applications for Medicaid and CHIP are open year-round - unlike the marketplace, there is no enrollment window to miss.

One more case: coverage during pregnancy

About 15 states use a CHIP option often called the "unborn child" or from-conception-to-end-of-pregnancy pathway to cover prenatal care and delivery for pregnant people who would not otherwise qualify. If you are pregnant and fall in the income gap, it is worth asking your state's program specifically about prenatal CHIP coverage - it is easy to miss because it does not look like "children's" coverage on the surface.

The bottom line

If your family earns too much for Medicaid, do not assume your kids are uninsurable or stuck with an expensive marketplace plan. In most states there is a middle band - CHIP - with an income ceiling far higher than parents expect, little or no cost, no asset test, and a full year of locked-in coverage once you enroll. Find your state's line before you rule it out.

Frequently asked questions

Our income went up mid-year. Will my kids lose CHIP?

Almost certainly not for the rest of the eligibility year. Federal 12-month continuous eligibility, in effect since January 1, 2024, keeps enrolled children covered for a full year even if your income rises above the limit before the next renewal.

We earn too much for Medicaid but a marketplace plan is expensive. Do our kids still have an option?

Usually yes - that gap is exactly what CHIP was built for. The kids' income line runs to a median of about 255% FPL and up to 400% in New York, well above the adult Medicaid cutoff.

Does CHIP count our savings, house, or car?

No. Children's eligibility is MAGI-based with no asset test. The asset test people worry about applies to long-term-care Medicaid for the elderly and disabled, not to kids.

Do the 2026 Medicaid work requirements apply to my children?

No. Work requirements apply only to certain adults in the expansion group. Children and pregnant enrollees are exempt, and CHIP is not subject to them at all.