How To Apply for CHIP: Step‑by‑Step Guide to Where and How You Apply

The Children’s Health Insurance Program (CHIP) helps many families get low‑cost health coverage for their children and sometimes for pregnant people. This guide walks you through how to apply for CHIP and where you actually submit your application, using typical processes that many states follow.

HowToGetAssistance.org is an informational resource only. You cannot apply or enroll here. To get CHIP, you must use official state or federal channels, such as your state’s CHIP/Medicaid agency, the official benefits portal, or an authorized local office.

What CHIP Is (In Plain English)

CHIP is a public health coverage program that usually:

• Covers children up to age 19 (exact age limit varies by state)
• Helps families whose income is too high for Medicaid but still limited
• Often includes doctor visits, checkups, prescriptions, emergency care, and more
• Usually has low or no premiums and low co-pays for covered services

Every state runs its own version of CHIP, sometimes under a state‑specific name. The federal government sets broad rules, but the exact income limits, benefits, and application process can differ from one state to another.

Who Typically Qualifies for CHIP

Only an official agency can decide if someone is eligible. However, you can get a general idea of who often qualifies:

Common Eligibility Factors

Most states look at:

• Age: Child under a certain age (often under 19)
• Residency: The child must live in the state where you apply
• Citizenship/Immigration status: Rules vary by state; some states cover certain lawfully present children
• Household income: Based on household size and countable income
• Other insurance coverage: Whether the child has other health insurance

Typical Signs You Might Be Within the Range

You may want to apply for CHIP if:

• Your child does not qualify for Medicaid because your income is slightly higher
• Your employer coverage is too expensive to add your child
• You do not have employer coverage at all, or you can’t afford marketplace plans

Again, these are general clues. To know for sure, your state’s CHIP or Medicaid agency must review a completed application.

Key Documents to Gather Before You Apply

Having documents ready can make your CHIP application smoother. States may ask for different items, but commonly requested documents include:

Identity & Personal Information

• Birth certificates or other proof of age for each child
• Social Security numbers (if available) for household members applying
• Photo ID for the parent or guardian (driver’s license, state ID, etc.)

Citizenship / Immigration (if required in your state)

• U.S. passport, Certificate of Naturalization, or birth certificate
• Immigration documents (for lawfully present noncitizens), such as a green card or other eligible status documents

Residency & Address

• Lease, mortgage statement, or rent receipt
• Utility bill, bank statement, or government letter showing your current address

Income & Employment

• Recent pay stubs (often last 4 weeks or last month)
• Employer letter stating wages and hours, if pay stubs are not available
• Unemployment benefit statements
• Social Security or disability benefit letters
• Self‑employment records (invoices, tax returns, profit and loss statements)

Other Coverage

• Insurance cards if anyone already has coverage
• Letters about loss of coverage or upcoming end of employer coverage

If you are missing some documents, many states allow you to submit the application first and then send additional proof later. Your local agency or official hotline can explain what is absolutely required to start the process.

Where You Can Apply for CHIP

You do not apply through HowToGetAssistance.org. You must use official channels. Most states offer several ways to apply:

Common Application Paths

Because CHIP is closely tied to Medicaid and the health insurance marketplace, some states use one combined application for Medicaid, CHIP, and marketplace financial assistance. In those places, you submit one application, and the agencies decide which program fits your situation.

How to Find the Correct Official CHIP Application for Your State

The exact website or office name is different in each state, so it’s important to make sure you are on an official government site or speaking with an authorized office.

Here are some ways to identify the right place:

1. Look for your state’s health or human services agency.
   These often have names like:

   • Department of Health and Human Services (HHS)
   • Department of Social Services (DSS)
   • Department of Human Services (DHS)
   • Medicaid or Health Care Services agency

2. Check the state’s main government portal.
   Use the state’s official website (often ends in “.gov”) and navigate to:

   • “Health Care”
   • “Medicaid / CHIP”
   • “Family & Children’s Services”

3. Use the official health insurance marketplace.
   Many families apply through the health insurance marketplace website or hotline. These can route your application to Medicaid or CHIP if you appear eligible.

4. Call an official hotline.

   • Your state’s Medicaid or CHIP customer service number
   • The federal marketplace call center
   • 2‑1‑1 (in many areas) to get connected to local health coverage help

When in doubt, call a local county human services office or health department and ask, “Where do I submit an application for CHIP in this county?”

Step‑by‑Step: How to Apply for CHIP

The details vary by state, but the general process often looks like this.

Step 1: Gather Basic Information

Before you start:

• Names, dates of birth, and Social Security numbers (if available) for everyone applying
• Your current address and contact information
• Income information (pay stubs, benefit statements, etc.)
• Details about any current health coverage

You don’t always need everything perfect to begin, but having this ready usually makes the process faster.

Step 2: Choose How You Want to Apply

Most people choose one of these methods:

1. Online application

   • Go to your state’s official benefits or Medicaid/CHIP website.
   • Create an account (if required).
   • Choose the application for Medicaid/CHIP or health coverage for families/children.
   • Answer all questions honestly and completely.

2. Phone application

   • Call your state’s Medicaid/CHIP hotline or the official marketplace call center.
   • Tell them you want to apply for CHIP or coverage for your children.
   • A representative will ask you the questions from the application and complete it for you over the phone.

3. Paper application (mail/fax)

   • Get a paper application from:
     • A local Medicaid or human services office, or
     • Your state agency’s website (you can usually print it).
   • Fill out all sections that apply to your household.
   • Sign and date it.
   • Mail or fax it to the address or number listed on the form.

4. In‑person application

   • Visit a local county human services office, Medicaid office, or health department that accepts applications.
   • Ask for help applying for CHIP or children’s health coverage.
   • Staff may assist you in completing the form and copying documents.

Step 3: Submit Required Documents

After you submit the application, you may be asked to provide proof of:

• Identity and age
• Residency
• Income
• Citizenship or immigration status (as allowed/required in your state)

How you submit documents depends on your state:

• Upload through the online portal
• Mail copies (never mail your only original if possible)
• Fax copies to the official number
• Bring them to a local office in person

If you receive a letter asking for more information, note the deadline. Missing that date can delay or close your application.

Step 4: Watch for Notices and Requests

After applying, your state agency may:

• Send letters explaining if they need more information
• Call you to clarify details
• Notify you of your approval, denial, or need for additional proof

Keep your mailing address, phone number, and email up to date with the agency. If you move or change phone numbers, contact them right away.

Step 5: Receive the Decision

Processing times vary by state, but many applications are decided within several weeks. You will usually receive:

• A notice of eligibility (approval or denial)
• Information on which children are covered, for what dates
• Details about plan options, if your state uses managed care plans
• Instructions for choosing a primary care provider if required

Only an official notice from your state CHIP/Medicaid agency or marketplace counts as a decision.

What Happens After You’re Approved for CHIP

If your child is found eligible:

• Coverage generally begins on a specific start date, sometimes retroactive to a month before application (depends on state rules).
• You may receive a CHIP or Medicaid card in the mail.
• In some states, you pick a health plan from a list of managed care organizations.
• You’ll be told about any copays (for example, small fees for prescriptions or doctor visits) and if there is a monthly premium.

Your child will usually keep coverage for a set period (often 12 months) as long as you report major changes, such as:

• Significant income changes
• Moving out of the state
• Gaining other health insurance

Your state will typically send a notice when it’s time to renew.

Common Reasons CHIP Applications Are Delayed or Denied

Only the official agency can tell you the exact reason for a denial, but these are common issues that can cause problems:

Frequent Delays

• Missing documents (e.g., no proof of income or residency)
• Incomplete application (sections left blank that should be filled)
• Unclear income information (inconsistent pay stubs, not reporting self‑employment clearly)
• Not responding to requests for additional information by the deadline

Typical Denial Reasons

• Income is above your state’s limit for CHIP
• The child does not meet age or residency requirements
• The child qualifies for Medicaid instead, and you’ll be directed there
• The child has other health coverage that conflicts with CHIP rules in your state

If you get a denial notice, read it carefully. It should explain:

• Why you were denied
• Whether your child was evaluated for Medicaid
• How to appeal the decision
• Deadlines for appeals or submitting corrections

How Appeals and Reviews Usually Work

If you believe a decision was made in error:

1. Read your notice fully.
   It should include written instructions on appeal rights and timelines.

2. File an appeal or request for a fair hearing.

   • This often must be done in writing by a certain deadline.
   • Some states allow you to appeal online or by phone as well.

3. Provide additional information.

   • Gather any updated or missing documents.
   • Explain clearly why you think the decision is wrong (for example, an income figure was incorrect).

4. Participate in the hearing or review.

   • You may be able to speak with a hearing officer by phone or in person.
   • In some areas, legal aid organizations or community advocates can help you prepare.

Only the official agency or hearing office can change the decision. Follow all deadlines and instructions listed in your notice carefully.

If You Don’t Qualify for CHIP: Other Paths to Explore

If your child is not eligible for CHIP, you may still have options:

• Medicaid: If your income is lower, your child may qualify for Medicaid instead. Many states use the same application for Medicaid and CHIP.
• Health insurance marketplace: You may qualify for premium tax credits or cost‑sharing reductions to lower the cost of a private plan.
• Employer coverage: Check whether you can add your child to a job‑based plan, and compare the costs.
• Local clinics and community health centers:
  Some offer sliding‑scale fees based on income for children’s care, vaccinations, and basic services.
• State or county programs:
  A few states and counties run separate children’s coverage or medical assistance programs for families who don’t meet CHIP rules.

To explore these options, you can:

• Contact your state health or human services agency
• Call the official health insurance marketplace call center
• Dial 2‑1‑1 in many areas to ask about low‑cost or no‑cost local health services

Tips to Avoid Scams and Make Sure You’re Using an Official CHIP Channel

Because you must share sensitive information (Social Security numbers, income, addresses), it’s important to be sure you are using real government or authorized resources.

Here are practical safeguards:

• Check the web address

  • Official state sites usually end with “.gov”.
  • Be cautious of sites that ask for fees to “guarantee approval” or that don’t clearly identify a state or federal agency.

• Confirm phone numbers

  • Get phone numbers directly from your state’s official site, the back of your Medicaid/CHIP card (if you already have one for someone else), or printed materials from government offices.

• Avoid paying for application help

  • Many states offer free application assistance through community organizations, local health departments, or “navigators”/assisters for the marketplace.
  • Be wary of anyone who guarantees approval or asks for money to submit your CHIP application.

• Protect your documents

  • Only share personal documents with verified agencies or authorized helpers.
  • Ask which agency they work for and how your information will be used.

If something seems suspicious, contact your state Medicaid or CHIP office directly and ask how to apply safely.

By understanding what CHIP is, who it typically covers, and where and how to apply through official channels, you can take clear steps toward getting health coverage for your child. Use your state’s official benefits portal, Medicaid/CHIP agency, or marketplace resources to submit your application, respond promptly to any document requests, and follow the instructions on your official notices for next steps.