Texas CHIP: Children's Health Insurance Program

Last verified: June 2026

~201%

FPL income limit

Separate

Not merged into Medicaid

Perinatal

Unique prenatal program

Up to $50

/year family enrollment fee

Apply once — HHSC automatically determines Medicaid vs CHIP

A single application at YourTexasBenefits.com covers both Children's Medicaid (STAR) and CHIP. If your child earns too much for Medicaid, HHSC will automatically check CHIP eligibility. Don't let uncertainty about which program applies prevent you from applying.

Texas has a separate CHIP program — not folded into Medicaid

Unlike California, which merged its CHIP program into Medi-Cal, Texas maintains CHIP as a distinct program from Medicaid. Children who earn too much for Children's Medicaid (STAR) are evaluated for CHIP. The income thresholds, cost sharing, and some benefit details differ between the two programs. Apply for both at once through YourTexasBenefits.com — HHSC automatically determines which program applies.

How Texas CHIP works and who runs it

Texas CHIP is funded by the federal Title XXI Children's Health Insurance Program and administered by HHSC. It provides health coverage for children whose family income is too high to qualify for Children's Medicaid but who cannot afford private insurance. CHIP covers children ages 0–18 at up to approximately 201% FPL — picking up where Medicaid (133% FPL) leaves off.

Like Children's Medicaid (STAR), Texas CHIP delivers services through managed care organizations. Families choose from health plans available in their service area. Many MCOs participate in both STAR (Medicaid) and CHIP, so families may be able to keep the same health plan if a child transitions from Medicaid to CHIP or vice versa as family income changes.

Unlike Medicaid, CHIP charges small enrollment fees and copays in some income ranges. These are capped to keep coverage affordable — see the cost sharing section below.

Who qualifies for Texas CHIP?

To qualify for Texas CHIP, a child must meet all of these requirements:

Age 18 or younger (some children with disabilities up to age 20 may qualify)
Texas resident
U.S. citizen or qualified non-citizen
Family income within CHIP income guidelines (see table below)
Not currently covered by private or employer-sponsored health insurance

The income requirement for CHIP applies to the entire household. If a child's income is too high for Medicaid (above ~133% FPL / $3,564/month for a family of four) but within the CHIP limit (~201% FPL / $5,386/month for a family of four), HHSC will enroll them in CHIP automatically when you apply.

Texas CHIP income limits by household size (2026)

The following monthly income limits are effective March 2026, per the official HHSC CHIP income guidelines. Income is gross household income before taxes.

Household size	Monthly income limit
1 person	$2,622
2 people	$3,543
3 people	$4,464
4 people	$5,386
5 people	$6,307
6 people	$7,228
7 people	$8,149
Each additional person	add $922

Source: HHSC CHIP income guidelines, effective March 2026 (hhs.texas.gov). These figures use the 2026 FPL update effective March 1, 2026, per HHSC Bulletin 26-04.

CHIP enrollment fees and copays

Texas CHIP charges a small annual enrollment fee per family and copays for some services, depending on income. These are designed to keep costs manageable while ensuring families have some financial stake in coverage.

Income level	Annual enrollment fee	Copays (doctor visit / Rx)
Below ~150% FPL	$0	$3–$5
~150%–201% FPL	Up to $50/family/year	$20–$35

Source: HHSC CHIP program overview (hhs.texas.gov). Enrollment fees are per family per year, not per child. CHIP has a dental services cap; services beyond the cap require prior authorization from your dental plan.

CHIP Perinatal: coverage for unborn children of ineligible pregnant women

CHIP Perinatal is a unique Texas program that covers the unborn child of a pregnant woman who does not qualify for full Medicaid and does not have other health insurance. It is one of the few programs of its kind in the country. The program name reflects that coverage attaches to the unborn child (the "perinate"), not to the mother directly.

CHIP Perinatal covers prenatal care visits, prenatal vitamins, labor and delivery, and two doctor visits for the baby within 60 days after the pregnancy ends. The income limit for CHIP Perinatal is approximately 202% FPL ($2,687/month for an individual, $5,555/month for a family of four, per HHSC 2026 guidelines).

To qualify, the pregnant woman must be a Texas resident, not have other health insurance, and meet the income guidelines. Citizenship requirements differ slightly from regular CHIP — documented immigrants and certain qualified non-citizens may qualify for CHIP Perinatal even if they are not eligible for regular Medicaid.

Apply for CHIP Perinatal as early as possible

Prenatal care is most effective when started in the first trimester. Do not wait until later in pregnancy to apply. HHSC will tell you at application which program — Medicaid for Pregnant Women or CHIP Perinatal — applies to your situation. Apply at YourTexasBenefits.com or call 2-1-1.

What Texas CHIP covers for children

Texas CHIP covers a broad set of health services for enrolled children. Per HHSC, CHIP benefits include:

Regular doctor and dental checkups
Prescription drugs and vaccines
Hospital care (inpatient and outpatient)
X-rays and laboratory tests
Vision and hearing care
Specialist visits and referrals
Mental health and substance use treatment
Treatment of pre-existing conditions and special health care needs

CHIP does not cover long-term services and supports for children with disabilities. If your child has a disability and needs LTSS, look into the Medicaid Buy-In for Children (MBIC) program or STAR Kids, which are available for children who meet disability criteria regardless of whether they qualify for standard CHIP.

What Texas CHIP covers

Texas CHIP covers a broad set of health services. Per HHSC, covered benefits include:

Doctor visits — well-child checkups and sick visits
Hospital care — inpatient and outpatient
Emergency and urgent care services
Prescription drugs and vaccines
Mental health and substance use treatment
Dental care — preventive and restorative (via CHIP dental MCO)
Vision care, including eye exams and glasses
Laboratory and imaging services
Physical, occupational, and speech therapy
Medical equipment when medically necessary (wheelchairs, hearing aids)

CHIP does not cover long-term services and supports. Children with disabilities needing LTSS should look into STAR Kids or the Medicaid Buy-In for Children (MBIC) program.

Children's Medicaid (STAR) vs Texas CHIP: key differences

Feature	STAR (Medicaid)	CHIP
Income limit	133% FPL	~201% FPL
Premiums	None	Up to $50/family/year
Copays	None (or minimal)	$3–$35 depending on income
Emergency coverage	Cannot deny for unpaid fees	Cannot deny for unpaid fees
Delivery model	STAR managed care	CHIP managed care (similar MCOs)

CHIP and Medicaid income ranges overlap — apply regardless

If you're not sure whether your child qualifies for Medicaid or CHIP, apply at YourTexasBenefits.com anyway. HHSC determines which program applies automatically. A child who earns out of Medicaid may qualify for CHIP and vice versa.