May 25, 2022

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Children’s Health Insurance: Who’s eligible and how to apply?

Medicaid and the Children’s Health Insurance Program (CHIP) provide free or low-cost health coverage to millions of Americans.

Medicaid services protect low-income people, families and children, pregnant women, the elderly, and people with disabilities.

Even some states expanded their Medicaid programs to cover certain income levels.

Even if you don’t qualify for Medicaid based on income, you should apply.

You may qualify for your state’s program, especially if you have children, are pregnant, or have a disability.

You can apply for Medicaid any time of year. Medicaid and CHIP do not have Open Enrollment Periods.

How to apply to Medicaid and Children’s Health Insurance Program?

1. Through the Health Insurance Marketplace

Fill out your application.

-If it looks like anyone in your household qualifies for Medicaid or CHIP, we’ll send your information to your state agency. They’ll contact you about enrollment.

-When you submit your Marketplace application, you’ll also find out if you qualify for an individual insurance plan with savings based on your income instead. Plans may be more affordable than you think.

2. Through your state Medicaid agency

-You can also apply directly to your state Medicaid agency.

Other ways of eligibility

The Affordable Care Act established a consistent methodology for determining income eligibility, which is based on Modified Adjusted Gross Income.

MAGI is used to determine financial eligibility for CHIP, Medicaid, and the health insurance marketplace.

It is intended to make it easier for people to apply and enroll in the appropriate program.

To be eligible for CHIP, a child must be:

-Under 19 years of age,

-Uninsured (determined ineligible for Medicaid, and not covered through a group health plan or creditable health insurance),

-A citizen or meet immigration requirements,

-A resident of the state, and

-Eligible within the state’s CHIP income range, based on family income, and any other state specified rules in the CHIP state plan.