Texas has one of the highest rates of uninsured children in the United States, yet many Texas families with kids don't realize that two public programs — Medicaid and the Children's Health Insurance Program (CHIP) — together cover children in households earning up to 217% of the Federal Poverty Level. For a family of four in 2026, that's roughly $66,000 per year. If your child doesn't have health insurance and your household income is below that threshold, there's a very good chance your child qualifies for one of these programs today.
This guide explains how Texas CHIP and Medicaid for children work, who qualifies, how to apply, what's covered, and how these programs compare to each other and to ACA marketplace plans.
Many parents don't realize that Texas actually has two programs covering children, and the distinction matters for what you pay. Texas Medicaid covers children in households from 0% to 198% of the Federal Poverty Level. For 2026, that's up to approximately $60,500 per year for a family of four. Medicaid has no monthly premiums and no copays — coverage is fully subsidized.
Texas CHIP picks up where Medicaid leaves off, covering children in households at 201% to 217% FPL — roughly $61,400 to $66,300 for a family of four. CHIP charges small monthly premiums (typically $35–$50 per family per month) and modest copays for services such as office visits ($3–$5 per visit) and brand-name prescriptions ($5 per prescription). These costs are far below private insurance rates and are intentionally designed to be affordable for working families.
Note the narrow gap between 198% and 201% FPL — there is a short eligibility gap in that range. Households in that sliver should contact Texas HHSC directly to understand their options, as program parameters can change annually.
Texas CHIP provides comprehensive health coverage for enrolled children. Covered services include:
Texas CHIP is delivered through managed care organizations — insurers contracted by the state to administer benefits. In most Texas regions, families choose from multiple CHIP plans during enrollment, including options from Aetna Better Health of Texas, Amerigroup Texas, and others depending on county. The plans share a benefit set but may have different provider networks, so checking your child's current doctor is in-network is important when selecting a CHIP plan.
Texas's CHIP Perinatal program is a unique provision that covers prenatal and labor-and-delivery services for the unborn children of uninsured pregnant women. It is available to pregnant women whose income falls between 198% and 217% FPL and who do not have other health insurance coverage.
It is important to understand what CHIP Perinatal is and is not. The program technically provides coverage for the fetus, not the mother. The pregnant woman receives prenatal care visits, labor and delivery services, and newborn care — but only services directly tied to the pregnancy and the baby's wellbeing. The mother's own health conditions not related to the pregnancy are generally not covered. Once the baby is born, the newborn transitions to regular CHIP or Medicaid coverage based on household income, while the mother is not automatically enrolled in any program.
For uninsured pregnant women at this income level, CHIP Perinatal can be the difference between accessing prenatal care and going without. Apply as early as possible in the pregnancy through YourTexasBenefits.com.
Texas uses a single application system for both Medicaid and CHIP for children. You do not need to specify which program you're applying for — the system determines eligibility based on your household income and family size. There are three ways to apply:
Documents you'll need to gather before applying:
Most applications are processed within 45 days. If your situation is urgent — for example, a child with an immediate medical need — ask about expedited processing.
Texas CHIP and Medicaid require annual renewal. Texas HHSC will send a renewal notice before your child's coverage expires. It is critical to respond to this notice on time. If you miss the renewal deadline, coverage will be terminated and you'll need to reapply, potentially leaving your child uninsured for weeks.
Common reasons families lose CHIP or Medicaid coverage include: not updating their address (so renewal notices go to an old address), not responding within the deadline, or a modest income increase that pushes the household just above the eligibility threshold. If your income has increased since your last renewal, you may still qualify — income thresholds adjust annually with FPL changes, and the threshold for a larger family is substantially higher.
For families whose children qualify for CHIP, the program almost always provides better value than an ACA marketplace plan. Here's why:
The main scenario where a marketplace plan might be preferred for a child is if the family's other members are already on a marketplace plan and adding the child to the family plan makes administrative sense, or if a specific specialist or hospital is not available in any CHIP managed care network in the area.
However, the ACA's rules prevent families from claiming marketplace premium tax credits for family members who are eligible for CHIP or Medicaid. If your child is CHIP-eligible, you generally cannot get marketplace subsidies for that child — another reason to enroll eligible children in CHIP rather than a marketplace plan.
One important point for Gulf Coast Texas families: even if you as a parent fall in the Medicaid gap (see our Texas Medicaid Gap Guide), your children may still qualify for CHIP or Medicaid. The parents' own ineligibility does not affect the children's eligibility. A childless adult parent in the gap can simultaneously have their children fully covered through CHIP or Medicaid. Apply for your children's coverage regardless of your own situation.