District of Columbia CHIP: Children's Health Insurance Program

Last verified: June 2026

Informational overview of District of Columbia CHIP

For current eligibility thresholds and enrollment, visit https://dhcf.dc.gov/service/medicaid. CHIP and Medicaid applications are processed together in most states — apply once and both programs are considered.

DC does not have a separate CHIP program — children are covered through DC Medicaid up to 319% FPL

DC integrates children's coverage fully into DC Medicaid. There is no separately branded CHIP program. Children under age 19 qualify for DC Healthy Families (managed care Medicaid) at household incomes up to 319% FPL. Apply through a DHS IMA Service Center or call (202) 727-5355. The same application covers adults and children.

How DC covers children — fully integrated with Medicaid

DC uses its full Medicaid program to cover children, rather than maintaining a separate CHIP program with distinct branding, benefits, or administration. DC funds children's coverage above the federal Medicaid floor using CHIP Title XXI funds — but from the member's perspective, it is all "DC Medicaid" through DC Healthy Families.

This integration means there is no gap between Medicaid and CHIP benefits, no separate enrollment process, and no different managed care plans at different income levels. Children up to 319% FPL receive the same comprehensive DC Medicaid benefit package regardless of whether their coverage is technically funded through Medicaid or CHIP dollars.

Who qualifies for children's coverage in DC

Child must be under age 19
Must be a DC resident
Must be a U.S. citizen or qualifying immigrant
Household income at or below 319% FPL — approximately $110,000/year for a family of 4 in 2026
No separate CHIP application — one DHS application covers all income levels

Source: DHCF Medicaid page (dhcf.dc.gov/service/medicaid). Monthly income figure is approximate based on 2026 HHS Federal Poverty Guidelines. Verify exact dollar threshold with DHCF at (202) 727-5355.

Benefits for children in DC Healthy Families

DC Medicaid/DC Healthy Families provides comprehensive coverage for enrolled children, including dental and vision as explicitly listed benefits. Children receive EPSDT-scope dental care, which covers all medically necessary dental services.

Well-child and preventive care visits
Immunizations
Doctor visits and specialist referrals
Emergency and urgent care
Inpatient hospital care
Prescriptions
Dental care (comprehensive EPSDT scope)
Eye care and vision services
Mental health and substance use treatment
Physical, occupational, and speech therapy
Home and community-based services when medically necessary
Non-emergency medical transportation

Source: DHCF Medicaid page (dhcf.dc.gov/service/medicaid); federal EPSDT mandate (42 U.S.C. § 1396d(r)).

DC children's coverage compared to other jurisdictions

At 319% FPL, DC's children's coverage threshold is among the highest in the country — comparable to Vermont's Dr. Dynasaur (312% FPL). A family of four earning up to approximately $110,000 per year qualifies their children for DC Medicaid in 2026. This reflects DC's policy of near-universal coverage for children and its ability to use CHIP funds to extend coverage well above the standard Medicaid floor. The federal government covers a significant share of CHIP costs, making DC's investment in children's coverage cost-effective relative to its broad policy goals.

What CHIP is

CHIP — the Children's Health Insurance Program — is a federal-state partnership that covers children in families whose income is too high for Medicaid but too low to afford private insurance. Congress created CHIP in 1997 under Title XXI of the Social Security Act. Like Medicaid, CHIP is jointly funded by the federal government and each state, and each state administers its own program.

CHIP serves children up to age 19 (some states cover to 21 for children in foster care). It is not available to adults — CHIP is specifically designed to address the coverage gap for children in working families.

Nationally, CHIP covers approximately 7 million children, according to CMS data. In most states, it is a seamless part of the broader children's health coverage system alongside Medicaid.

What CHIP covers

Federal law requires CHIP to cover certain core benefits. States may add to the list. Standard CHIP coverage includes:

Doctor visits, including well-child checkups and sick visits
Hospital care — inpatient and outpatient
Emergency room and urgent care services
Prescription drug coverage
Mental health and substance use disorder services
Dental care — preventive and restorative
Vision care, including eye exams and glasses
Laboratory and imaging services
Physical, occupational, and speech therapy
Medical equipment, such as wheelchairs or hearing aids when medically necessary

How to apply for District of Columbia CHIP

Apply through DC Medicaid — the same application covers both Medicaid and CHIP. Online applications are typically fastest and allow document uploads. You can also apply by phone or in person at a local eligibility office.

See the how to apply page for the complete application process, required documents, and what to expect during review.

CHIP and Medicaid income ranges overlap — apply regardless

If you're not sure whether your child qualifies for Medicaid or CHIP, apply anyway. The eligibility system determines which program applies based on your income. A child who earns out of Medicaid may qualify for CHIP, and vice versa. Don't let uncertainty about which program applies prevent you from applying.