New Jersey CHIP: Children's Health Insurance Program

Last verified: June 2026

Informational overview of New Jersey CHIP

For current eligibility thresholds and enrollment, visit https://www.state.nj.us/humanservices/dmahs/home/. CHIP and Medicaid applications are processed together in most states — apply once and both programs are considered.

There is no separate CHIP program in New Jersey

Unlike most states, New Jersey does not operate a separate CHIP program under a different name. Both Medicaid-funded and CHIP-funded children's coverage flows through NJ FamilyCare — one program, one application, one insurance card. The program determines behind the scenes whether federal Medicaid or CHIP dollars fund your child's coverage. You don't need to know the difference to apply.

Who does NJ FamilyCare cover for children?

NJ FamilyCare covers children from birth through age 18 (and in some cases up to age 21 for certain categories) at income levels up to 355% of the Federal Poverty Level. For a family of four, that ceiling is roughly $115,000 per year in 2026 — one of the highest income thresholds for children's public health coverage in the country.

Children are citizens or qualifying immigrants, live in New Jersey, and have household income below 355% FPL. No asset test applies.

Income tiers and premium structure

Household income (% FPL)	Monthly premium per child	Funding source
0–138% FPL	None	Medicaid
138%–200% FPL	None	Medicaid / CHIP
200%–355% FPL	~$40–$50/month (family cap applies)	CHIP

Premium amounts update annually. Verify current figures at NJHelps.gov or by calling 1-800-701-0710.

The family cap on premiums means a family with multiple children in the 200%–355% FPL band pays a capped monthly amount, not a per-child multiplier with no ceiling. The exact cap amount is set by DMAHS annually.

What's covered for children

All children enrolled in NJ FamilyCare receive the same comprehensive benefit package regardless of which income tier they fall into. Federal EPSDT rules apply to all children under 21, meaning any medically necessary service must be covered — even if New Jersey's standard benefit plan doesn't list it explicitly.

Well-child visits and developmental screenings
Immunizations per CDC schedules
Specialist care, including pediatric specialists
Hospital and emergency care
Prescription drugs
Dental (comprehensive under EPSDT — including orthodontia when medically necessary)
Vision, including glasses
Mental health and behavioral health services
Substance use disorder treatment

Applying for a child

Apply at NJHelps.gov. One application covers the entire household — children and adults apply together, and the system determines which category and funding source applies to each family member. You don't need to know whether your child qualifies under Medicaid or CHIP rules; NJHelps handles that determination.

You can also apply through GetCoveredNJ if you're also shopping for adult marketplace coverage. The system routes children to NJ FamilyCare automatically if their income falls below 355% FPL, even if the adults in the household end up on a marketplace plan instead.

Processing takes up to 45 days, but coverage starts the first day of the application month if approved. A child born to an NJ FamilyCare-enrolled mother is automatically enrolled in NJ FamilyCare from birth and has one year of continuous eligibility regardless of changes in the household's income.

What happens if income increases above 355% FPL?

Children whose family income rises above 355% FPL are no longer eligible for NJ FamilyCare. At that point, families can purchase coverage through the ACA marketplace (GetCoveredNJ) and may qualify for premium tax credits depending on income. The transition is not automatic — families need to apply for marketplace coverage separately if NJ FamilyCare eligibility ends.

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 New Jersey CHIP

Apply through NJ FamilyCare (New Jersey 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.