CHIP for Children in Texas: Eligibility, Benefits, and Enrollment 2026

Texas CHIP provides low-cost health insurance for children and teens up to age 18 in families earning up to 201% of the Federal Poverty Level (FPL) in 2026.
For a family of three, the 201% FPL income limit for CHIP is approximately $51,848 annually.
CHIP offers comprehensive benefits including doctor visits, hospital care, prescriptions, dental, and vision, with low monthly enrollment fees (capped at 5% of income) and small co-payments.
Families can apply for CHIP and Medicaid for children through the Texas Health and Human Services website, yourtexasbenefits.com.

Updated July 2026 · Texas-Plans.com — Licensed Health Insurance Producer (NPN #21249133)

Ensuring children have access to quality healthcare is a top priority for families in Texas. The Children's Health Insurance Program (CHIP) in Texas offers a vital safety net, providing low-cost comprehensive health coverage for children and teens who don't qualify for Medicaid but whose families can't afford private insurance. With healthcare costs steadily rising, understanding CHIP eligibility and benefits can be crucial for Texas families looking to protect their children's health without breaking the bank. This guide breaks down the 2026 CHIP program in Texas, covering who qualifies, what's covered, and how to enroll.

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Understanding CHIP: A Bridge to Coverage for Texas Children

CHIP, or the Children's Health Insurance Program, is a federal-state partnership designed to provide health coverage to children in families who earn too much to qualify for Medicaid but cannot afford or access other health insurance options. In Texas, this program is administered by the Texas Health and Human Services Commission (HHSC). It ensures that children from birth through age 18 can receive necessary medical care, from routine check-ups and immunizations to emergency services and specialized treatments. For families balancing household budgets, CHIP offers a crucial alternative to being uninsured, preventing medical debt and promoting long-term health for their children.

CHIP Income and Eligibility Requirements in Texas for 2026

Eligibility for CHIP in Texas primarily depends on your household income relative to the Federal Poverty Level (FPL), as well as other factors such as residency and lack of other affordable coverage. For 2026, Texas CHIP generally covers children in families with incomes up to 201% of the FPL. It's important to note that these income thresholds are for children; adults without dependent children in Texas (a non-Medicaid expansion state) face a coverage gap if their income is below 100% FPL, as they typically do not qualify for Medicaid. The table below outlines the 2026 Federal Poverty Levels and the approximate income limits for CHIP eligibility in Texas:

Household Size	100% FPL	138% FPL (Medicaid for Children)	201% FPL (CHIP Eligibility)
1 person	$15,060	$20,783	$30,271
2 people	$20,440	$28,207	$41,084
3 people	$25,820	$35,632	$51,848
4 people	$31,200	$43,056	$62,652
5 people	$36,580	$50,480	$73,456
6 people	$41,960	$57,905	$84,260
7 people	$47,340	$65,329	$95,064
8 people	$52,720	$72,754	$105,868
+1 additional	+$5,380	+$7,424	+$10,810
Source: HHS 2025 Federal Poverty Guidelines (applied to 2026 ACA plan year). CHIP eligibility is typically 201% FPL in Texas.

To qualify for CHIP, your child must also:

Be under 19 years old.
Be a Texas resident.
Be a U.S. citizen or qualified non-citizen.
Not be eligible for Medicaid.
Not have other affordable health insurance coverage.

The application process will first check for Medicaid eligibility; if a child does not qualify for Medicaid due to income, their eligibility for CHIP will then be assessed.

Comparing Coverage Options: CHIP vs. Marketplace and Medicaid

When considering health coverage for your children in Texas, it's helpful to understand how CHIP fits alongside other options like Medicaid and plans from HealthCare.gov. The best choice depends on your family's income and specific needs.

Income Level (for a family of 3)	FPL %	Recommended Coverage	Typical Cost	Why This Option
Under $35,632	Under 138% FPL	Texas Medicaid (for children)	$0	Comprehensive coverage with no out-of-pocket costs for eligible children.
$35,632 – $51,848	138% – 201% FPL	Texas CHIP	Low monthly fees, small co-pays	Affordable, comprehensive coverage for children who don't qualify for Medicaid.
$51,848 – $64,550	201% – 250% FPL	ACA Marketplace Silver Plan (with CSR)	~$100–$200 (after subsidies)	Children may transition to marketplace plans; Cost-Sharing Reductions (CSR) significantly lower deductibles and out-of-pocket maximums on Silver plans.
$64,550 – $103,280	250% – 400% FPL	ACA Marketplace Gold or Silver Plan (with APTC)	Varies (after subsidies)	Premium Tax Credits (APTC) make plans more affordable; Gold plans offer lower out-of-pocket costs for higher medical use.
Above $103,280	Above 400% FPL	ACA Marketplace (any tier) or Off-Exchange Plan	Full premium	Full cost of premiums; may consider Bronze or HDHP + HSA for healthy families.
All costs are approximate and depend on specific plan, carrier, and household details. Adult coverage may differ.

Key Benefits and Cost-Sharing for Texas CHIP

Texas CHIP is designed to provide comprehensive healthcare services that promote children's health and development. The program covers a wide range of benefits, ensuring that children receive necessary medical care without families facing prohibitive costs. Benefits typically include:

Regular Check-ups and Doctor Visits: Routine care to monitor growth and development.
Immunizations: All recommended vaccinations.
Prescription Drugs: Coverage for necessary medications.
Hospital Care: Inpatient and outpatient hospital services.
Emergency Services: Coverage for urgent medical needs.
Dental Care: Routine cleanings, fillings, and other dental services.
Vision Care: Eye exams and glasses.
Mental Health Services: Counseling and other behavioral health support.
Specialty Care: Access to specialists when needed.

While CHIP is low-cost, it's not entirely free for most families. There are typically two types of costs:

Monthly Enrollment Fees: These fees vary based on your income and household size, but they are capped at 5% of your family's gross monthly income. Many families with incomes below 150% FPL may not have any enrollment fees.
Co-payments: Small fees paid at the time of service for certain medical care, such as doctor visits or prescription drugs. Preventive services, like well-child check-ups and immunizations, are typically free.

These cost-sharing amounts are significantly lower than those found in most private insurance plans, making healthcare accessible and affordable for thousands of Texas families.

Health Insurance in Texas: What Families Need to Know

Texas operates on the federal health insurance marketplace, HealthCare.gov. While the marketplace offers subsidized plans for adults and children, CHIP provides an even more affordable option for children within its income thresholds. Texas has not expanded its Medicaid program, which means adults without dependent children generally do not qualify for Medicaid regardless of income. However, children's Medicaid eligibility is more expansive, covering children up to 138% FPL. For pregnant women, Texas offers Medicaid for Pregnant Women (MPW) covering up to 200% FPL, and CHIP Perinatal for unborn children up to 201% FPL. When looking for health insurance in Texas, families should understand that PPO plans are generally not available on-exchange through HealthCare.gov. The primary plan types offered on the marketplace are Health Maintenance Organization (HMO) and Exclusive Provider Organization (EPO) plans. These plans typically have more restricted networks than PPOs, requiring members to use in-network providers for most services. For families whose children qualify for CHIP, the program offers a clear path to comprehensive, low-cost coverage, regardless of these marketplace plan structure differences.

Steps to Enroll Your Children in Texas CHIP

Enrolling your children in CHIP is a straightforward process designed to ensure eligible families can access benefits quickly.

Gather Necessary Information: Collect income documentation (pay stubs, tax returns), proof of Texas residency, Social Security numbers for all family members, and any existing health insurance information.
Apply Online: The most common way to apply is through the Texas Health and Human Services website, yourtexasbenefits.com. You can also apply by mail, phone, or in person at a local HHSC office. The application will determine eligibility for both Medicaid and CHIP.
Await Eligibility Determination: After submitting your application, the HHSC will review your information to determine if your children qualify for Medicaid or CHIP. This process typically takes a few weeks.
Enroll in a Health Plan: If approved for CHIP, you will receive information about choosing a managed care health plan available in your area. You'll select a plan that best fits your family's needs.
Pay Enrollment Fees (if applicable): If your income requires a monthly enrollment fee, you will need to pay this to activate coverage.
Utilize Benefits: Once enrolled, your children can start receiving medical care through their chosen plan.

Navigating health insurance options can be complex, but you don't have to do it alone. A licensed health insurance agent can provide free, unbiased assistance, helping you understand your family's eligibility for CHIP, Medicaid, or marketplace subsidies, and guiding you through the enrollment process.

Frequently Asked Questions

What is the income limit for CHIP in Texas for 2026?

In Texas for 2026, children in families with incomes up to 201% of the Federal Poverty Level (FPL) are generally eligible for CHIP. For a family of three, this means an annual income up to approximately $51,848. Eligibility also depends on other factors, such as not qualifying for Medicaid and not having access to affordable health insurance.

What benefits does CHIP cover for children in Texas?

Texas CHIP provides comprehensive health coverage for children. This includes regular check-ups, doctor visits, hospital care, prescription drugs, dental care, vision care, mental health services, and immunizations. The program aims to cover all essential health benefits to ensure children receive the care they need to stay healthy.

How much does CHIP cost in Texas?

The costs for CHIP in Texas are typically very low. Most families pay a small monthly enrollment fee, which varies based on income but is capped at 5% of the family's gross income. There are also small co-payments for some services, but many preventive services are free. Families with incomes below 150% FPL may have no enrollment fees or co-payments at all.

Where can I apply for CHIP in Texas?

You can apply for CHIP in Texas through the Texas Health and Human Services Commission (HHSC) website at yourtexasbenefits.com. You can also apply by phone, mail, or in person at a local HHSC office. The application process will also determine if your children are eligible for Medicaid, as both programs are managed through the same application.

What is the difference between Medicaid and CHIP for children in Texas?

In Texas, both Medicaid and CHIP provide low-cost health coverage for children. The primary difference is income eligibility: Medicaid is for children in families with very low incomes (generally below 133% FPL), while CHIP serves children in families who earn too much for Medicaid but cannot afford private insurance (up to 201% FPL). CHIP may have small enrollment fees and co-payments, whereas Medicaid typically has no out-of-pocket costs.