[{"data":1,"prerenderedAt":675},["ShallowReactive",2],{"/en/guides/child-benefits/medicaid-for-children-eligibility":3},{"id":4,"title":5,"body":6,"category":644,"description":645,"extension":646,"faq":647,"meta":666,"navigation":667,"path":668,"publishedAt":669,"relatedCalculator":670,"seo":671,"stem":672,"updatedAt":673,"__hash__":674},"guides_en/en/guides/child-benefits/medicaid-for-children-eligibility.md","Medicaid for Children 2026: Eligibility, Income Limits & How to Apply",{"type":7,"value":8,"toc":622},"minimark",[9,13,22,29,34,37,105,110,129,133,140,230,236,240,247,252,257,271,276,296,301,312,317,328,333,344,349,360,364,368,375,379,391,395,402,406,409,413,430,436,440,447,452,471,475,478,538,544,548,555,562,566,569,593,601,605],[10,11,5],"h1",{"id":12},"medicaid-for-children-2026-eligibility-income-limits-how-to-apply",[14,15,16,17,21],"p",{},"Health insurance for children is not a luxury — it is a necessity that determines whether kids receive timely care or fall through the cracks. For millions of American families, ",[18,19,20],"strong",{},"Medicaid and CHIP (Children's Health Insurance Program)"," provide free or low-cost comprehensive coverage for children under 19, regardless of pre-existing conditions.",[14,23,24,25,28],{},"In 2026, approximately ",[18,26,27],{},"37 million children"," are enrolled in Medicaid or CHIP, making it the largest source of health coverage for American kids. Yet millions more who qualify have never applied. This guide covers eligibility rules, income limits, what's covered, and exactly how to enroll.",[30,31,33],"h2",{"id":32},"medicaid-vs-chip-understanding-the-two-programs","Medicaid vs. CHIP: Understanding the Two Programs",[14,35,36],{},"Both Medicaid and CHIP are jointly funded by the federal government and states, but they serve different income levels:",[38,39,40,59],"table",{},[41,42,43],"thead",{},[44,45,46,50,53,56],"tr",{},[47,48,49],"th",{},"Program",[47,51,52],{},"Who It Covers",[47,54,55],{},"Typical Income Range",[47,57,58],{},"Cost to Family",[60,61,62,77,91],"tbody",{},[44,63,64,68,71,74],{},[65,66,67],"td",{},"Medicaid",[65,69,70],{},"Lowest-income children",[65,72,73],{},"Up to 133–138% FPL",[65,75,76],{},"Free (no premiums, no copays)",[44,78,79,82,85,88],{},[65,80,81],{},"CHIP",[65,83,84],{},"Low-to-moderate income",[65,86,87],{},"138% to 200–300% FPL",[65,89,90],{},"Low premiums, small copays",[44,92,93,96,99,102],{},[65,94,95],{},"Medicaid expansion (some states)",[65,97,98],{},"Higher thresholds",[65,100,101],{},"Up to 400% FPL",[65,103,104],{},"Varies",[14,106,107],{},[18,108,109],{},"FPL (Federal Poverty Level) for 2026:",[111,112,113,117,120,123,126],"ul",{},[114,115,116],"li",{},"Family of 1: $15,650",[114,118,119],{},"Family of 2: $21,150",[114,121,122],{},"Family of 3: $26,650",[114,124,125],{},"Family of 4: $32,150",[114,127,128],{},"Each additional person: +$5,500",[30,130,132],{"id":131},"income-limits-by-family-size-2026","Income Limits by Family Size (2026)",[14,134,135,136,139],{},"Most states cover children at ",[18,137,138],{},"200% FPL or higher",". Here are the annual gross income thresholds at common coverage levels:",[38,141,142,158],{},[41,143,144],{},[44,145,146,149,152,155],{},[47,147,148],{},"Family Size",[47,150,151],{},"138% FPL (Medicaid)",[47,153,154],{},"200% FPL (CHIP common)",[47,156,157],{},"300% FPL (higher states)",[60,159,160,174,188,202,216],{},[44,161,162,165,168,171],{},[65,163,164],{},"2",[65,166,167],{},"$29,187",[65,169,170],{},"$42,300",[65,172,173],{},"$63,450",[44,175,176,179,182,185],{},[65,177,178],{},"3",[65,180,181],{},"$36,777",[65,183,184],{},"$53,300",[65,186,187],{},"$79,950",[44,189,190,193,196,199],{},[65,191,192],{},"4",[65,194,195],{},"$44,367",[65,197,198],{},"$64,300",[65,200,201],{},"$96,450",[44,203,204,207,210,213],{},[65,205,206],{},"5",[65,208,209],{},"$51,957",[65,211,212],{},"$75,300",[65,214,215],{},"$112,950",[44,217,218,221,224,227],{},[65,219,220],{},"6",[65,222,223],{},"$59,547",[65,225,226],{},"$86,300",[65,228,229],{},"$129,450",[14,231,232,235],{},[18,233,234],{},"States with the highest CHIP income limits"," (as of 2026): New York (400% FPL), New Jersey (350% FPL), and California (266% FPL) provide the most generous coverage. Always check your specific state's thresholds, as they are updated annually.",[30,237,239],{"id":238},"what-does-medicaid-cover-for-children","What Does Medicaid Cover for Children?",[14,241,242,243,246],{},"Children enrolled in Medicaid are entitled to ",[18,244,245],{},"EPSDT (Early and Periodic Screening, Diagnostic, and Treatment)"," services — a comprehensive benefit unique to Medicaid for those under 21. EPSDT requires states to cover all medically necessary services, even services not covered for adults.",[248,249,251],"h3",{"id":250},"covered-services","Covered Services",[14,253,254],{},[18,255,256],{},"Preventive care:",[111,258,259,262,265,268],{},[114,260,261],{},"Well-child exams at recommended intervals (14 visits from birth through age 21)",[114,263,264],{},"Immunizations and vaccines",[114,266,267],{},"Developmental screenings",[114,269,270],{},"Lead level testing",[14,272,273],{},[18,274,275],{},"Medical care:",[111,277,278,281,284,287,290,293],{},[114,279,280],{},"Inpatient and outpatient hospital care",[114,282,283],{},"Doctor visits (primary care and specialists)",[114,285,286],{},"Prescription drugs",[114,288,289],{},"Lab tests and X-rays",[114,291,292],{},"Mental health and behavioral health services",[114,294,295],{},"Substance use disorder treatment",[14,297,298],{},[18,299,300],{},"Dental care:",[111,302,303,306,309],{},[114,304,305],{},"Routine checkups and cleanings",[114,307,308],{},"Fillings and extractions",[114,310,311],{},"Orthodontia if medically necessary",[14,313,314],{},[18,315,316],{},"Vision care:",[111,318,319,322,325],{},[114,320,321],{},"Annual eye exams",[114,323,324],{},"Eyeglasses (frames and lenses)",[114,326,327],{},"Contact lenses when medically indicated",[14,329,330],{},[18,331,332],{},"Hearing:",[111,334,335,338,341],{},[114,336,337],{},"Hearing evaluations",[114,339,340],{},"Hearing aids",[114,342,343],{},"Follow-up services",[14,345,346],{},[18,347,348],{},"Therapy:",[111,350,351,354,357],{},[114,352,353],{},"Speech therapy",[114,355,356],{},"Physical therapy",[114,358,359],{},"Occupational therapy",[30,361,363],{"id":362},"how-to-apply-for-medicaid-or-chip","How to Apply for Medicaid or CHIP",[248,365,367],{"id":366},"option-1-apply-online-at-healthcaregov","Option 1: Apply Online at HealthCare.gov",[14,369,370,371,374],{},"Go to ",[18,372,373],{},"healthcare.gov"," and complete a coverage application. The system will automatically determine if your child qualifies for Medicaid, CHIP, or a subsidized marketplace plan.",[248,376,378],{"id":377},"option-2-apply-directly-through-your-state","Option 2: Apply Directly Through Your State",[14,380,381,382,386,387,390],{},"Every state has a Medicaid agency with an online portal. Search \"",[383,384,385],"span",{},"your state"," Medicaid application\" or go to ",[18,388,389],{},"medicaid.gov/state-overviews"," for direct links to all 50 states.",[248,392,394],{"id":393},"option-3-call-the-marketplace","Option 3: Call the Marketplace",[14,396,397,398,401],{},"Call ",[18,399,400],{},"1-800-318-2596"," (24/7) to apply by phone and get enrollment assistance.",[248,403,405],{"id":404},"option-4-in-person-assistance","Option 4: In-Person Assistance",[14,407,408],{},"Local Medicaid offices, community health centers, hospitals, and school-based clinics often have enrollment counselors who can help you apply for free.",[248,410,412],{"id":411},"documents-you-may-need","Documents You May Need",[111,414,415,418,421,424,427],{},[114,416,417],{},"Proof of child's identity (birth certificate)",[114,419,420],{},"Proof of citizenship or immigration status (for the child)",[114,422,423],{},"Social Security Numbers for the child and applying parent",[114,425,426],{},"Proof of household income (pay stubs, tax returns, benefits letters)",[114,428,429],{},"Proof of address (utility bill, lease)",[14,431,432,435],{},[18,433,434],{},"Presumptive eligibility:"," Many states offer same-day or immediate temporary coverage while your full application is reviewed, so your child can see a doctor the same day you apply.",[30,437,439],{"id":438},"enrollment-periods-and-special-rules","Enrollment Periods and Special Rules",[14,441,442,443,446],{},"Unlike marketplace insurance, ",[18,444,445],{},"Medicaid and CHIP have no open enrollment period",". You can apply any time of year, and coverage begins quickly — often within days of approval.",[14,448,449],{},[18,450,451],{},"Special situations:",[111,453,454,461,468],{},[114,455,456,457,460],{},"A ",[18,458,459],{},"newborn baby"," is automatically enrolled in Medicaid at birth if the mother is enrolled, and coverage is retroactive to the date of birth",[114,462,463,464,467],{},"A child who ",[18,465,466],{},"loses other health insurance"," (job-based, COBRA, etc.) qualifies for a Special Enrollment Period",[114,469,470],{},"Foster children and children in state custody are automatically eligible for Medicaid regardless of income",[30,472,474],{"id":473},"chip-premiums-and-cost-sharing","CHIP Premiums and Cost-Sharing",[14,476,477],{},"CHIP may involve small costs depending on your state and income:",[38,479,480,493],{},[41,481,482],{},[44,483,484,487,490],{},[47,485,486],{},"Income Level",[47,488,489],{},"Typical Monthly Premium",[47,491,492],{},"Copays",[60,494,495,506,517,528],{},[44,496,497,500,503],{},[65,498,499],{},"Below 150% FPL",[65,501,502],{},"Usually $0",[65,504,505],{},"Little or none",[44,507,508,511,514],{},[65,509,510],{},"150–200% FPL",[65,512,513],{},"$0–$25 per family",[65,515,516],{},"$1–$5 per visit",[44,518,519,522,525],{},[65,520,521],{},"200–300% FPL",[65,523,524],{},"$25–$50 per family",[65,526,527],{},"$5–$10 per visit",[44,529,530,533,536],{},[65,531,532],{},"Above 300% FPL",[65,534,535],{},"Varies widely",[65,537,104],{},[14,539,540,543],{},[18,541,542],{},"Federal rule:"," CHIP cost-sharing cannot exceed 5% of annual family income for families enrolled in CHIP. For most families, the out-of-pocket costs remain very low.",[30,545,547],{"id":546},"maintaining-coverage-renewal","Maintaining Coverage: Renewal",[14,549,550,551,554],{},"Medicaid and CHIP eligibility is reviewed annually. Most states now conduct ",[18,552,553],{},"automatic renewals"," using data from other government sources (IRS, SSA, state wage records). If your income hasn't changed significantly, you may be renewed without doing anything.",[14,556,557,558,561],{},"If your state cannot automatically verify eligibility, you will receive a renewal notice asking you to provide updated information. ",[18,559,560],{},"Missing this deadline causes a coverage gap"," — return the renewal paperwork promptly.",[30,563,565],{"id":564},"related-benefits-for-children-and-families","Related Benefits for Children and Families",[14,567,568],{},"Medicaid for children is often just the starting point. Eligible families frequently qualify for additional support:",[111,570,571,579,586],{},[114,572,573,578],{},[574,575,577],"a",{"href":576},"/en/guides/child-benefits/wic-benefits-2026/","WIC Benefits 2026"," — free nutrition support for children under 5 and pregnant mothers, free regardless of Medicaid status",[114,580,581,585],{},[574,582,584],{"href":583},"/en/guides/child-benefits/snap-benefits-calculator-2026/","SNAP Benefits Calculator 2026"," — food assistance for the whole household",[114,587,588,592],{},[574,589,591],{"href":590},"/en/guides/child-benefits/child-tax-credit-2026/","Child Tax Credit 2026"," — up to $2,000 per child in tax refunds",[14,594,595,596,600],{},"Use our ",[574,597,599],{"href":598},"/calculator/","Family Benefits Calculator"," to estimate your total benefit entitlement.",[30,602,604],{"id":603},"related-guides","Related Guides",[111,606,607,612,617],{},[114,608,609,611],{},[574,610,577],{"href":576}," — nutrition assistance for children under 5",[114,613,614,616],{},[574,615,591],{"href":590}," — federal tax credit for families with children",[114,618,619,621],{},[574,620,584],{"href":583}," — food assistance eligibility and amounts",{"title":623,"searchDepth":624,"depth":624,"links":625},"",2,[626,627,628,632,639,640,641,642,643],{"id":32,"depth":624,"text":33},{"id":131,"depth":624,"text":132},{"id":238,"depth":624,"text":239,"children":629},[630],{"id":250,"depth":631,"text":251},3,{"id":362,"depth":624,"text":363,"children":633},[634,635,636,637,638],{"id":366,"depth":631,"text":367},{"id":377,"depth":631,"text":378},{"id":393,"depth":631,"text":394},{"id":404,"depth":631,"text":405},{"id":411,"depth":631,"text":412},{"id":438,"depth":624,"text":439},{"id":473,"depth":624,"text":474},{"id":546,"depth":624,"text":547},{"id":564,"depth":624,"text":565},{"id":603,"depth":624,"text":604},"child-benefits","Complete guide to Medicaid and CHIP for children in 2026 — income limits by family size, free preventive care, dental and vision coverage, and step-by-step application instructions.","md",[648,651,654,657,660,663],{"question":649,"answer":650},"What is the income limit for Medicaid for children in 2026?","Income limits vary by state. Most states cover children up to 200–300% of the Federal Poverty Level (FPL). At 200% FPL, a family of four can earn up to approximately $62,400 per year. CHIP extends coverage further in states with higher thresholds. Some states cover children up to 400% FPL.",{"question":652,"answer":653},"What is the difference between Medicaid and CHIP for children?","Medicaid is a joint federal-state program for the lowest-income families — children typically qualify at 133–138% FPL. CHIP (Children's Health Insurance Program) fills the gap for children in families that earn too much for Medicaid but cannot afford private insurance, generally covering up to 200–300% FPL depending on the state.",{"question":655,"answer":656},"What does Medicaid cover for children?","Medicaid for children covers well-child visits, immunizations, doctor visits, hospital care, prescription drugs, mental health services, dental care, vision care including glasses, and hearing aids. The EPSDT (Early and Periodic Screening, Diagnostic, and Treatment) benefit ensures broad coverage for all medically necessary services.",{"question":658,"answer":659},"How do I apply for Medicaid or CHIP for my child?","You can apply through your state's Medicaid agency, through HealthCare.gov, by calling 1-800-318-2596, or in person at your local Medicaid office. Many states also allow same-day presumptive eligibility so your child can receive care while the full application is processed.",{"question":661,"answer":662},"Can my child get Medicaid if I am undocumented?","Children who are US citizens (including children born in the US to undocumented parents) are eligible for Medicaid based on their own citizenship status, not their parents'. Undocumented children may qualify for emergency Medicaid in most states, and some states offer full state-funded coverage regardless of immigration status.",{"question":664,"answer":665},"Is there a cost for children's Medicaid?","Standard Medicaid for children has no premiums and no copayments for most services. CHIP may have modest premiums (typically $0–$50/month per child) and small copayments for some services. Costs depend on the state and the family's income level.",{},true,"/en/guides/child-benefits/medicaid-for-children-eligibility","2026-03-31","/child-benefits-calculator",{"title":5,"description":645},"en/guides/child-benefits/medicaid-for-children-eligibility",null,"PfhhJCoyV7aVeDdtI_hBptUd6DTROH3G5fBksGVBHyY",1775557777049]