Massachusetts CHIP: Children's Health Insurance Program

Last verified: June 2026

Informational overview of Massachusetts CHIP

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

Massachusetts integrates CHIP funding into MassHealth — children apply through the same portal

Massachusetts uses CHIP (Title XXI) federal funding to cover children at income levels above standard Medicaid but at or below 300% FPL. There is no separate CHIP program in Massachusetts — all children apply for MassHealth through a single application at mahix.org/individual/ or by calling (800) 841-2900.

Who qualifies for children's MassHealth (including CHIP)

MassHealth covers children ages 0–18 with family income up to 300% of the Federal Poverty Level. For a family of four, 300% FPL is approximately $93,600 per year (2025 FPL base). Children at or below 150% FPL typically receive MassHealth Standard (Medicaid-funded). Children between 150% and 300% FPL are covered through CHIP funding as MassHealth Family Assistance.

Child must be under age 19
Family income at or below 300% FPL (approximately $93,600/yr for a family of 4)
Child must be a U.S. citizen, national, or qualified non-citizen
Child must reside in Massachusetts
Child must be uninsured or meet MassHealth residency and citizenship requirements

Source: MassHealth eligibility information (mass.gov/information-for-masshealth-applicants); 2025 HHS FPL applied at 300%.

MassHealth Family Assistance: Massachusetts's CHIP delivery mechanism

MassHealth Family Assistance is the coverage type that uses CHIP federal funding for children between approximately 150% and 300% FPL. It provides the same comprehensive benefits as MassHealth Standard — including EPSDT dental, vision, and behavioral health services — with minimal cost-sharing.

Unlike states where CHIP has a distinct identity (KidsCare, FAMIS, CoverKids), Massachusetts has fully merged CHIP into the MassHealth system. There is no separate CHIP enrollment, no separate CHIP card, and no separate CHIP customer service line. All children's coverage flows through MassHealth.

What MassHealth covers for children

Well-child checkups and immunizations
Primary care doctor visits
Specialist referrals
Prescriptions
Emergency and urgent care
Inpatient hospital care
Mental health and substance use disorder services
Dental care (full EPSDT scope — through Delta Dental of Massachusetts)
Vision screenings and eyeglasses
Physical, occupational, and speech therapy
Orthodontics when medically necessary

Premiums and cost-sharing for children

MassHealth Standard (for children at or below approximately 150% FPL) has no monthly premiums. MassHealth Family Assistance (CHIP-funded, 150%–300% FPL) charges small monthly premiums for some households — amounts vary by income and family size. Verify your specific premium at the time of application or at MassHealth member services.

Well-child visits, immunizations, and preventive services are not subject to co-pays for children in any MassHealth program. Small co-pays may apply to some non-emergency services.

How to apply for children's MassHealth coverage

Apply for MassHealth at mahix.org/individual/ using your MA Login account. You can also apply by calling MassHealth at (800) 841-2900 or by visiting a MassHealth Enrollment Center in person. A single application covers all eligible household members for MassHealth and ConnectorCare.

Children of undocumented parents can apply for MassHealth

Eligible children can apply for MassHealth regardless of their parents' immigration status. Parents applying only for their children do not need to provide their own Social Security numbers. MassHealth has maintained this policy for years and explicitly addresses it in its eligibility guidance.

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 Massachusetts CHIP

Apply through MassHealth (Massachusetts 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.