CHIP (Children’s Health Insurance Program) for immigrants

CHIP is a federal-state program covering health insurance for uninsured children from families earning too much for Medicaid but unable to afford private insurance.

Who qualifies?

US-citizen children

YES qualify without restrictions (subject to state income limits).

Permanent-resident children (green card)

  • No 5-year bar where the state elected the “CHIPRA 214 option” — a state election, not a federal rule. Counting CMS’s own current table, updated April 2, 2026, the option covers children in 37 states, the District of Columbia and 3 territories, and pregnant women in 31 states, DC and 3 territories — 43 jurisdictions in all have elected it for one group or the other, and the two columns are not the same states. Check yours in CMS’s table of Medicaid and CHIP coverage of lawfully residing children and pregnant women.
  • In the states that did not elect it: the 5-year bar applies

Refugee, asylee, specific-status children

The answer changes on October 1, 2026, and both halves matter.

  • Through September 30, 2026 — YES qualify without the 5-year bar, in every state. CMS states the rule plainly: “some noncitizens (e.g., refugees and asylees) are exempted from the five-year waiting period.”
  • Beginning October 1, 2026 — refugee and asylee children are not on the list of groups federal money will pay for. This is the biggest change on this page; the full section is below.

Undocumented children

Do NOT qualify federally. However:

  • 14 states + DC (CA, NY, IL, OR, WA, MA, MN, CO, CT, ME, NJ, RI, VT, etc.) extend CHIP-like coverage to undocumented children with state funds

Income limits

Vary by state. Typically covers up to 200-300% of federal poverty level. Measured against the 2026 HHS poverty guidelines, 100% of the poverty level for a household of four in the 48 contiguous states and DC is $33,000 , so a 200-300% CHIP range is roughly $66,000 -$99,000 a year. Alaska and Hawaii use higher guidelines, and the number that decides your case is the one your state publishes — those are on each state page.

How to apply

  1. Healthcare.gov (federal Marketplace) — most states process via Marketplace
  2. Your state’s Medicaid/CHIP portal
  3. Single application for Medicaid AND CHIP — state automatically determines which program

Coverage: what federal law requires, and what it leaves to your state

Dental is required. The statute is not permissive about it: the child health assistance provided to a targeted low-income child “shall include coverage of dental services necessary to prevent disease and promote oral health, restore oral structures to health and function, and treat emergency conditions” (42 U.S.C. 1397cc(c)(6)(A)).

The basic categories every benchmark package must cover are inpatient and outpatient hospital services; physicians’ surgical and medical services; laboratory and x-ray; well-baby and well-child care including age-appropriate immunizations; and mental health and substance use disorder services (42 U.S.C. 1397cc(c)(1)).

Vision, hearing and prescription drugs sit in a different bucket. The statute lists them under “Categories of additional services” — "(A) Coverage of prescription drugs. (B) Vision services. (C) Hearing services" (42 U.S.C. 1397cc(c)(2)) — and does not require them. Coverage of eye exams and glasses is part of each state’s benefit package, not a federal guarantee. Ask your state what its plan covers.

Beginning October 1, 2026: federal money stops for some children who qualify today

Section 71109 of the 2025 law (H.R.1 / WFTC, Public Law 119-21) is written as a limit on federal payment, but CMS told states that beginning October 1, 2026 they must limit eligibility determinations for full Medicaid and CHIP to people for whom federal funding is available. It changes who the federal government will pay for, and CMS explained it to the states in letter SHO #26-001 (April 8, 2026).

Who federal funding still covers. Beginning October 1, 2026, federal financial participation for full Medicaid and CHIP benefits is limited to U.S. citizens and U.S. nationals, lawful permanent residents, Cuban/Haitian entrants, and Compact of Free Association (COFA) migrants — provided the person is a resident of one of the 50 states, DC or a U.S. territory.

Who it stops covering. CMS names the groups in its own words:

“Given these changes, beginning October 1, 2026, with limited exceptions, FFP will no longer be available for full Medicaid or CHIP benefits furnished to qualified noncitizens who are not also FFP-eligible noncitizens (e.g., asylees, refugees, parolees, or victims of trafficking) unless they have another immigration status or category that meets the definition of an FFP-eligible noncitizen.”

The route that survives for children, and CMS names a refugee when it describes it. The CHIPRA 214 option is one of only three exceptions in the statute, and CMS says it directly:

“If an applicant, who is not an FFP-eligible noncitizen, is a lawfully residing child or pregnant woman (e.g., a refugee) and meets all other eligibility requirements in the state, the applicant can be determined eligible for full Medicaid or CHIP benefits under the state’s CHIPRA 214 option.”

CMS adds that section 1903(v)(5) “did not make any changes to … coverage under the CHIPRA 214 option (if a state elects such option).” So for a refugee or asylee child, the question on October 1 becomes: did my state elect CHIPRA 214 for children? Per CMS’s table as of April 2, 2026, 37 states, DC and 3 territories did.

The other two exceptions are Emergency Medicaid — which CMS says is untouched, “section 1903(v)(5) of the Act did not make any changes to coverage of emergency Medicaid” — and Health Services Initiatives. Emergency Medicaid is Medicaid only; CMS notes it “does not apply to separate CHIPs.”

What CMS says about state money. CMS will not force states to fill the gap, and will not treat state-funded coverage as CHIP: “we do not consider coverage that a state might opt to continue providing with 100 percent state-only funds to be ‘CHIP’.” It also wrote that it “will not require states to provide state-only funded health coverage to qualified noncitizens for whom FFP is not available.”

What CMS does not say. CMS does not say what any individual state will decide to do with its own money, and it publishes no list of states that will or will not keep covering refugee and asylee children after October 1, 2026. We do not infer it either way — ask your state Medicaid or CHIP agency directly. CMS also acknowledges that the eligibility regulations still on the books do not match the new funding rule: “We acknowledge that these requirements will not be aligned with the FFP limitations … beginning October 1, 2026. We plan to update Medicaid and CHIP regulations in future notice and comment rulemaking.”

For how the same date works for pregnancy and childbirth, see who pays for prenatal care and the birth without immigration status.

Official source: Medicaid.gov CHIP

Last verified: 2026-09-24.

General procedural information for educational purposes. Not legal, tax, or immigration advice. Laws and fees change — verify with the issuing agency before taking action. For case-specific guidance, consult a licensed immigration attorney or other appropriate professional.