What they offer
CHIP and Children’s Medicaid both cover services need to keep kids healthy, including:
- Dentist visits, cleanings, and fillings
- Eye exams and glasses
- Choice of doctors, regular checkups, and office visits
- Prescription drugs and vaccines
- Access to medical specialists and mental health care
- Hospital care and services
- Medical supplies, X-rays, and lab tests
- Treatment of special health needs
- Treatment of pre-existing conditions
If a child getting Medicaid has a disability or long-lasting illness, we will find out if the child can get special services.
Can I get it?
To qualify, a child must be:
- Age 18 or younger*.
*Children up to age 20 can qualify for Medicaid in some cases.
- A Texas resident.
- A U.S. citizen or legal permanent resident.
What if I am not a U.S. citizen?
We do not ask about the citizenship or immigration status of the parent. Only the child must be a U.S. citizen or legal permanent resident in Texas to be considered for CHIP/Children’s Medicaid coverage.
Who can apply?
- Any adult who lives more than half the time with an uninsured child may apply. This includes parents, stepparents, grandparents, other relatives, legal guardians, or adult brothers or sisters.
- Anyone age 19 or younger who lives on their own can apply.
- A pregnant person of any age can apply for CHIP perinatal services for her unborn child or apply for Medicaid.
Your income is money you get paid before taxes are taken out. Children of families that earn higher incomes may also qualify in some cases. Download a PDF of the Income Guidelines Chart (PDF).
How much does it cost?
Children’s Medicaid is free
If we find your child can get Children’s Medicaid, there is no cost to your for service.
CHIP fees vary based on your income
If we find your child can get CHIP, your enrollment fee and co-pays will be based on your family’s income. Enrollment fees are $50 or less per family, per year. Co-pays for doctor visits and prescriptions range from $3 to $5 for lower-income families and $20 to $35 for higher-income families.
What if my child has previous coverage?
A child who enrolls in CHIP for the first time after being covered by private health insurance can expect to have a 90-day waiting period before CHIP coverage begins.
There are exceptions:
The 90-day waiting period does not apply to children who lost insurance coverage because:
- Their parents separated, divorced, or got remarried.
- A parent died.
- A parent lost the family's health insurance they had through work.
- A parent's COBRA benefits ended
- The Texas Employees Retirement System no longer covers the child.
- A parent's employer stopped offering dependent health coverage
The 90-day waiting period also does not apply to the following children:
- A child who has special health care needs.
- A child who lost CHIP coverage in another state.
- A child who lost coverage in Medicaid, CHIP, or any health insurance affordability program. This includes health insurance plans found on the Healthcare.gov website offering premium tax credits and cost-sharing reductions.
- A child whose health insurance premium costs more than 5 percent of the family's gross income.
- A child whos family health insurance premium that includes the child is more than 9.5 percent of the family's income.
In addition, HHSC can waive the 90-day waiting period if the agency determines a good cause exists based on facts in the application or information HHSC gets from other sources.