Preguntas y respuestas
Here are some questions and answers that may be helpful for families applying for free or low-cost health insurance for their children and teens.
P: Is my child eligible for Medicaid or CHIP?
A: States have different income eligibility rules, but in most states, children up to age 19 with family income up to $47,700 per year (for a family of four) may qualify for Medicaid or the Children’s Health Insurance Program (CHIP). En muchos estados, los ingresos familiares pueden ser aún mayores y aún si los niños pueden calificar. Young people up to age 21 may be eligible for Medicaid. Youth who have “aged out” of foster care can be covered under Medicaid until they reach age 26; there is no income limit for these youth.
Medicaid and CHIP coverage is for U.S. citizens and certain lawfully present immigrants.
To find information about the Medicaid and CHIP programs in your state, go to Learn About Programs in Your State or call 1-877 KIDS NOW (1-877-543-7669). When you call the free and confidential hotline, you will be connected to someone in your state who can help you learn whether your children may qualify and help you enroll them.
P: Mis hijos son adolescentes. Are they eligible for coverage, too?
A: Yes, in every state, children from birth until their 19th birthday may be eligible for coverage.
P: Tengo trabajo. ¿Mis hijos pequeños y adolescentes califican de todos modos?
A: Yes, many children who are eligible for Medicaid and CHIP are in families where one or both parents are working. Working parents may not have health coverage through their jobs or the health plans they are offered may not cover their children. Muchas familias trabajadoras no pueden pagar el seguro médico por cuenta propia.
P: Who can apply for Medicaid and CHIP for a child?
A: A parent, grandparent, guardian or other authorized representative can apply on behalf of a child. If you are a teenager living on your own, your state may allow you to apply for Medicaid on your own behalf or any adult may apply for you.
P: ¿Qué pasa si mis hijos pequeños y adolescentes ya están cubiertos por Medicaid o CHIP?
A: That’s great! They already have comprehensive health insurance. If you are having trouble finding the care your child needs, call the toll free number 1-877-KIDS-NOW (1-877-543-7669). If you are looking for a dentist for your child, enter your information in the “Find a Dentist for Your Kid” box on the Insurekidsnow.gov home page.
P: ¿Existe algún límite en el período que mi hijo puede permanecer inscrito en Medicaid o CHIP?
A: Los niños y los adolescentes pueden permanecer con cobertura mientras califiquen. You will need to renew their coverage once a year.
P: How do I know when to renew Medicaid or CHIP coverage for my child or teen?
A: El programa se pondrá en contacto con usted para hacerle saber que es momento de renovar la cobertura de su hijo.
P: What do Medicaid and CHIP cover?
A: All states provide comprehensive coverage for children, including:
- Exámenes médicos de rutina
- Visitas al médico
- Cuidado de salud odontológica y oftalmológica
- Cuidado de salud hospitalario de los pacientes hospitalizados y ambulatorios
- Servicios de laboratorio y rayos X
- Servicios de emergencia
Some specific benefits may be different from state to state.
P: How do I find a health care provider (doctor, dentist or pharmacist) in my area who accepts Medicaid or CHIP?
A: There are several things you can do to find a health care provider:
- If you already have a health care provider for your child, ask if he or she accepts Medicaid, CHIP, or the health plan you selected. If you've been getting care from a provider that doesn’t accept Medicaid, CHIP, or any of its health plans, you may be able to keep seeing that provider for a short time until you can find another provider, but you need to ask your state’s Medicaid or CHIP program, or the health plan you selected.
- Most Medicaid and CHIP programs and health plans have websites that tell you which providers are available.
- Call your state Medicaid or CHIP agency or your health plan’s member services department for help. The phone number is typically on eligibility letters or on the back of program enrollment cards. This information should also be available on your health plan’s website or your state Medicaid or CHIP agency website.
- Be sure to let your provider know that you are enrolled in Medicaid or CHIP, or give the name of your health plan when you make an appointment for care. If you are having trouble getting an appointment to see a doctor, call your state Medicaid or CHIP agency or your health plan’s member services department for help.
P: What do families pay for coverage under Medicaid and CHIP?
A: Depending on their income, many families will get free health coverage for their children and teens. Other families may be required to pay a modest enrollment fee or premiums, and copayments for specific services. El resto de la cobertura corre por cuenta del gobierno federal y su estado.
P: When can I apply for Medicaid and CHIP? Is there a certain time of year I can apply?
A: You can enroll in Medicaid or CHIP any time. There’s no special open enrollment period for Medicaid or CHIP. You can apply at HealthCare.gov or directly with your state Medicaid/CHIP agency.
P: How do I apply?
A: You can apply online, by phone, by mail or in person. You can apply using the online application or directly at your state’s Medicaid or CHIP agency. Or, to get more information and help call 1-877-KIDS-NOW (1-877-543-7669), a free and confidential hotline, to be connected directly to your state’s program.