Written by a parent, not a doctor. Nothing here is medical advice.

Childhood Cancer Lantern
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Texas program

Low-cost health insurance for an uninsured child (Texas CHIP)

Low-cost health insurance for an uninsured child whose family income is above the Medicaid limit.

What it is

Low-cost health insurance for an uninsured child whose family income is above the Medicaid limit.

Texas CHIP covers hospital care, cancer treatment and medicines. HHSC checks Medicaid first, then CHIP. An offer of work insurance alone does not block CHIP; being enrolled in that plan does.

Eligibility rules
  • The child must be under 19 and not enrolled in other health insurance.
  • The March 1, 2026 base monthly limit for four is $5,528, or 201% of poverty. The five-point allowance can extend the screen to about 206%.
  • HHSC tests free Medicaid before CHIP. An employer offer is different from insurance your child actually has.
What you get
  • A yearly family fee of $0, $35 or $50, plus copays based on income.
  • Doctors, hospital care, chemotherapy, prescriptions, dental and vision.
  • Preventive care with no copay.
  • A cap on the family’s total covered fees and copays.
What the help covers
  • Office copays are $5, $20 or $25. Inpatient copays are $35, $75 or $125, depending on income.
  • Fees and copays are capped at 5% of net family income under handbook D-1840. Receipts help HHSC check the cap.
If you decide to apply
  1. Ask your hospital financial counselor for help with the Medicaid and CHIP application at Your Texas Benefits.
  2. Have recent pay stubs and the dates any insurance started or ended ready.
  3. Ask the counselor to check your cancer team against the plans you can choose.

Your Texas Benefits (same application as Medicaid) · Official page ↗

After you apply
  • The usual review standard is 45 days. After approval, the enrollment cutoff and any required fee affect the start date: coverage may begin the next month or the month after that. Your counselor should confirm the date on the enrollment notice before any existing coverage is changed.
  • The enrollment notice names the start date, plan, annual fee and copays. Child coverage lasts 12 months.
Good to know

The enrollment notice gives the start date. A stated waiting period deserves prompt review with your counselor and CHIP enrollment broker.

Other details
  • The counselor and CHIP enrollment broker can check any stated waiting period against the rule in force for the enrollment date. Approval alone does not establish immediate coverage; the enrollment notice confirms the start date.
  • If income is too high, MBIC has a separate disability and income test. CSHCN may help with costs left after CHIP.

Federal background: Children’s Health Insurance Program.

Official sources
Ask your social worker

“If Medicaid says no, would CHIP cover our child's current cancer team, and what would the yearly fee and copays add up to?”

Why I’m asking: I want affordable coverage without interrupting treatment.

More background and detailed requirements
Additional program information and published rules

Who does what

The three parts, side by side. The agency decides; nobody on this page does.

You

Apply, say what insurance the child has and when any plan ended, pay the yearly fee, keep copay receipts.

Your social worker

Checks the insurance-status question, gets any waiting notice reviewed in writing, and confirms the plan network includes your oncology center.

The care team

Documents the child's serious health needs if a waiting notice appears.

Who decides
HHSC decides enrollment. The CHIP plan approves services
Ask your social worker
“Can you get HHSC to put the CHIP start date in writing, and confirm our oncology center is in the plan we pick?”

How to apply

First step: Apply at YourTexasBenefits.com or 877-541-7905 (option 2). It is the same application as Medicaid, and HHSC tests Medicaid first.

  1. Apply at YourTexasBenefits.com. HHSC tests Medicaid first.
  2. Keep copay receipts and ask for the 5% cap review before you reach it.

Official application / program page ↗

Where it starts: Your Texas Benefits (same application as Medicaid)

What to gather

  • Last 30 days of pay stubs
  • The end date and reason for any insurance the child had
  • A letter from the oncologist about the child's needs, in case a waiting notice appears

How long: Same 45-day standard as Medicaid. Coverage starts the first of the month after enrollment and the fee are received. 12 months of coverage.

What a yes looks like

An enrollment notice with the start date, plan, fee and copay income range.

What a no looks like, and the next move

Ask whether the reason is income, existing insurance or documents. Over income: file MBIC if your child is in treatment. Insured: keep the plan and apply for Medicaid as a second payer instead.

Watch out

  • If anyone says your child must wait 90 days, ask for the rule in writing and appeal: federal law has banned CHIP waiting periods since June 3, 2025 and the Texas handbook text is stale.
  • An employer offer is not insurance. Only a plan the child is actually on blocks CHIP.
  • Copays are per visit and per drug. Keep receipts and ask HHSC for the 5% cost-cap review before you hit it.

Dates that change this

2025-06-03: No CHIP waiting period is lawful anywhere after June 3, 2025.

2026-09-07: Texas handbook D-1720 still prints a 90-day waiting period; no implementation bulletin was found. Ask for the rule in writing and appeal. (not yet confirmed against the final rule)

The numbers and the rules

The arcane layer, kept on purpose. Checked September 8, 2026.

What it is worth

Full child coverage for four up to $5,528 a month. Yearly fee $0, $35 or $50. Office visit $5–$25. Inpatient $35–$125. Total costs capped at 5% of income.

  • $5,528/month — Family of four monthly income limit (201% FPL, base)
  • $0–$50/year — Annual family enrollment fee by income range
  • $5–$25 (per visit) — Office-visit copay by income range ($5 / $20 / $25)
  • $35–$125 (per admission) — Inpatient admission copay by income range ($35 / $75 / $125)

Covers: Doctors and specialists · Hospital and emergency care · Chemotherapy and prescription drugs · Dental and vision · Preventive care at $0

What it costs the family: Fee once a year plus small copays. Total cost-sharing capped at 5% of net family income (D-1840).

The eligibility facts, as published

Age max exclusive
19
Income percent fpl max
201
Uninsured condition
child cannot be on CHIP and other health insurance at the same time (D-1210); an employer offer is not coverage
Waiting period
none

The trap: If anyone says your child must wait 90 days, ask for the rule in writing and appeal: federal law has banned CHIP waiting periods since June 3, 2025 and the Texas handbook text is stale.

Where I read this

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