Oregon CHIP: Children's Health Insurance Program

Last verified: June 2026

How Oregon handles CHIP: one program, not two

The Oregon Health Authority's own description of OHP states that OHP is "Oregon's Medicaid and Children's Health Insurance Program." This is a meaningful difference from most states. States like Colorado, Iowa, and Connecticut operate CHIP under a separate brand — CHP+, Hawki, HUSKY B. Oregon absorbed CHIP into OHP and presents them as one program.

This integration simplifies enrollment for families. Parents don't need to determine whether their child qualifies for Medicaid (Title XIX) versus CHIP (Title XXI) — OHA makes that determination automatically based on household income. The child receives the same OHP Plus card, sees the same providers, and uses the same CCO regardless of which federal funding stream covers their care.

From the member perspective, OHP Plus for a child at 180% FPL looks identical to OHP Plus for a child at 80% FPL. The difference is in the back-end federal funding formula, not in the benefit package or provider network.

Income eligibility for children under OHP Plus

Oregon covers children ages 0 through 18 under OHP Plus at significantly higher income thresholds than the adult expansion level. Children in families with income up to approximately 300% of the Federal Poverty Level may qualify for OHP Plus at no cost.

For context, 300% FPL for a family of four in 2026 is approximately $93,600 per year. That covers a substantial share of Oregon working families whose employer-sponsored insurance is unaffordable.

There is no premium for children enrolled in OHP Plus, regardless of income within the eligible range. No co-pays apply to most services for children. Oregon does not offer a separate CHIP plan with cost-sharing at higher income levels — children who qualify are in the same full-benefit program.

Source: OHA Oregon Health Plan eligibility documentation. Verify current children's income thresholds using the OHP income chart (Form DE 5530) at sharedsystems.dhsoha.state.or.us. Exact limits change annually.

What OHP Plus covers for children

Children receive full OHP Plus benefits, which include the EPSDT mandate (Early and Periodic Screening, Diagnostic and Treatment) under 42 U.S.C. § 1396d(r). EPSDT requires coverage of all medically necessary services for members under age 21 — not just services listed in Oregon's Prioritized List. Specific benefits include:

• Well-child visits and periodic health assessments
• Immunizations per CDC schedule
• Vision — eye exams and glasses
• Dental — comprehensive coverage including orthodontics when medically necessary
• Hearing screenings and hearing aids
• Behavioral health and mental health services
• Substance use disorder treatment
• Physical, occupational, and speech therapy
• Specialty care and hospital services
• Prescription drugs
• Non-emergency medical transportation through CCO arrangements

Enrolling a child in OHP Plus

Apply at ONE.Oregon.gov or call 1-800-699-9075. Because OHP has no open enrollment period, you can apply at any time. Children losing employer-sponsored insurance qualify for a special enrollment pathway — apply within 60 days of losing other coverage.

Newborns born to OHP-enrolled mothers are automatically enrolled in OHP from birth. The birth counts as a qualifying event, and coverage begins the day the child is born. If the mother is not enrolled, the newborn can apply immediately and coverage can be backdated to the birth date if the application is submitted promptly.

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 Oregon CHIP

Apply through Oregon Health Plan (OHP) — 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.