If you have children, back-to-school season is a good time to review their health coverage. The two most common ways to insure kids are CHIP (alongside Medicaid) and Marketplace plans. Each has its own rules, costs, and advantages. Here is how to tell which one usually fits, with information based on official sources. Eligibility varies by state, so it is worth confirming the rules where you live.
CHIP: what it is and who it covers (year-round enrollment)
CHIP, the Children’s Health Insurance Program, offers low-cost or free coverage for children up to age 19 who have no other insurance. It works hand in hand with Medicaid: many states run both programs together to cover the kids of working families.
One key point is that enrollment is open all year. You do not have to wait for the Marketplace Open Enrollment period. If your children qualify, coverage can start right away, and you only need to renew it each year to keep it active. According to HealthCare.gov, in most states children up to age 19 in a family of four earning up to about $80,000 a year may qualify for Medicaid or CHIP, though the limit changes from state to state.
When the Marketplace is a better fit for kids
The Marketplace is the natural option when your children do not qualify for CHIP or Medicaid, for example if the family income is above your state’s range. In that case, kids are usually covered within the same family plan.
The Marketplace can also make sense if you want the whole family on the same plan, the same provider network, and the same deductible. If your income qualifies, tax credits lower the monthly premium and make the plan more affordable. You can review options for your family in our guide on the ACA for immigrants if your household has mixed immigration status.
How to know which one fits your income
A practical rule is to look at your family income and household size:
- If your income falls within your state’s Medicaid or CHIP range, those programs are almost always the most affordable option for children.
- If your income is above that range, the Marketplace with tax credits is usually the way to go.
- In households with income right at the edge, it pays to check both routes, because sometimes the kids qualify for CHIP while the adults go to the Marketplace.
If your income landed above 400% of the poverty level, also read what happens with the subsidy cliff to understand your options.
What your kids need before school (physicals, vaccines, preventive care)
Before the first day of school, it helps to have preventive services up to date. CHIP and Medicaid, as well as Marketplace plans, cover the basic care children need:
- Well-child visits and routine check-ups with the pediatrician.
- Vaccines by age, including boosters and the annual flu shot.
- Dental and vision services, which help catch problems that affect learning.
According to Medicaid.gov and InsureKidsNow.gov, these preventive services are part of children’s coverage, helping them start the new school year healthy and protected.
Enroll your children with bilingual help
Choosing between CHIP and the Marketplace is easier with someone who reviews your case. A bilingual agent can look at your income, tell you what your kids qualify for, and help you enroll them, at no cost to you. Request your quote here and we will guide you step by step.
Frequently asked questions
What is CHIP and who qualifies?
CHIP (the Children’s Health Insurance Program) is low-cost or free public coverage for children up to age 19. Kids qualify if they have no other insurance and the family income falls within the range each state sets. In most states, a family of four earning up to about $80,000 a year may qualify for Medicaid or CHIP, though the limit varies by state.
Is CHIP open all year?
Yes. Medicaid and CHIP enrollment is open year-round, not just during the Marketplace Open Enrollment period. If your children qualify, coverage can start right away, and you renew it each year to keep it active.
Can my kids be on a Marketplace plan?
Yes. If your children do not qualify for CHIP or Medicaid, they can enroll in a Marketplace plan, usually alongside the rest of the family. Depending on your income, you may get tax credits that lower the monthly premium.
Which one costs less?
CHIP and Medicaid generally cost the least for children who qualify, with little or no premiums and copays. A Marketplace plan usually costs more, although tax credits can lower the premium significantly. The best fit depends on your income and family size.
Does it cover vaccines and school check-ups?
Yes. CHIP and Medicaid cover well-child visits, age-appropriate vaccines, routine check-ups, and dental and vision services for children. Marketplace plans also include children’s preventive care at no extra cost.
How do I enroll my children?
You can apply for Medicaid or CHIP any time of year, or compare Marketplace plans for your family. A bilingual agent can review your income, tell you what your kids qualify for, and help you enroll them at no cost to you.
