Federal, exists in every state
Free child health coverage through FAMIS
FAMIS covers uninsured children under 19 whose income is above the Medicaid line.
What it is
FAMIS covers uninsured children under 19 whose income is above the Medicaid line.
This is federal background for the same Virginia application. It is folded into the state card.
What you get
If you decide to apply
Official sources
“If Medicaid does not fit, could FAMIS cover our child, and what would change about the care available?”
Why I’m asking: I want to understand which coverage could help and what the application involves.
More background and detailed requirements
How this works
FAMIS covers uninsured children under 19 whose income is above the Medicaid line.
Only an uninsured child can qualify; an employer offer alone is not coverage.
For four people, the January 13, 2026 monthly limit is $5,500, or $5,638 with the allowance.
- No premium, copayments or deductibles for covered services.
- Coverage lasts 12 months once enrolled.
- FAMIS has no uninsured waiting period.
- Medicaid’s full children’s benefit guarantee does not apply in FAMIS managed care; it does during temporary fee-for-service coverage.
- Retroactive coverage is newborn-only: birth in the three months before the application month, falling to two months in 2027.
- Ask the hospital social worker to review the Virginia program with you.
FAMIS has no uninsured waiting period.
Medicaid’s full children’s benefit guarantee does not apply in FAMIS managed care; it does during temporary fee-for-service coverage.
Retroactive coverage is newborn-only: birth in the three months before the application month, falling to two months in 2027.
Additional program information and published rules
Who does what
The three parts, side by side. The agency decides; nobody on this page does.
You
File the state application, answer the insurance question exactly (enrolled versus offered), and pay the first premium when the letter comes.
Your social worker
Checks which range the child falls in and whether the state runs CHIP inside Medicaid or as a separate plan.
The care team
Records and letters when the application asks for them.
- Who decides
- The state Medicaid/CHIP agency
- Ask your social worker
- “Does my child fall under Medicaid or CHIP? If CHIP, what is the premium and when do the 12 months of coverage start?”
How to apply
First step: Apply through the same state application as Medicaid. The state sorts the child into Medicaid or CHIP by income.
- Apply through the state's Medicaid application. The state sorts Medicaid or CHIP.
- If told to wait, ask for the rule in writing and appeal.
Where it starts: The same state application as Medicaid. The state sorts the child by income
What to gather
- Pay stubs or this month's income
- Who lives at home
- Proof the child has no other insurance (a letter from the employer if asked)
How long: Same time limit as Medicaid: up to 45 days.
What a yes looks like
A letter naming the CHIP plan, the premium and the start date.
What a no looks like, and the next move
If the reason is “has other insurance”, ask which coverage they mean. An offer is not coverage. If the reason is income, the disability options are next.
Watch out
- Separate CHIP is for uninsured children. An employer plan you were offered but did not take is not insurance. Enrolled is what counts.
- If you are told to wait 90 days, ask for the rule in writing and appeal. Since June 3, 2025 no CHIP waiting period is lawful anywhere.
- A missed premium cannot end coverage inside the 12-month period. A renewal you ignore can.
Dates that change this
2025-06-03: No CHIP waiting period is lawful anywhere for applications after June 3, 2025; a state handbook that still prints 90 days is stale. Ask for the rule in writing and appeal.
2025-01-15: A state may not suspend CHIP for a missed premium during the child’s 12-month period.
The numbers and the rules
The arcane layer, kept on purpose. Checked September 7, 2026.
What it is worth
Full child coverage with state-set premiums and copays, capped at 5% of family income. 12 months once enrolled.
Covers: Doctor and specialist visits · Hospital and emergency care · Prescription drugs · Dental and vision · Preventive care
Legal protection: No waiting period is lawful anywhere for applications after June 3, 2025 · Premiums and cost-sharing together capped at 5% of family income · 12 months of continuous coverage. A missed premium cannot suspend it inside that period
What it costs the family: Small premiums and copays set by the state. The state record has the table.
The eligibility facts, as published
- State specific
- yes
- Age
- under 19
- Insurance status
- separate CHIP requires the child to be uninsured; an employer offer is not coverage
- Waiting period
- none lawful after 2025-06-03
Decisions this site cannot make: State income and household calculation
Expect friction on: Insurance-status rules · Plan network
The trap: An employer plan you were offered but did not take is not insurance for CHIP. Enrolled is what counts. And no CHIP waiting period is lawful anywhere since June 3, 2025.
What changes by state: Name, income ceiling, premium, and whether it is Medicaid-run or a separate plan.
Where I read this
- Children’s Health Insurance Program — Centers for Medicare & Medicaid Services, read August 27, 2026
- Continuous Eligibility for Medicaid and CHIP — Centers for Medicare & Medicaid Services, read August 27, 2026
- State Health Official letter 25-001: continuous eligibility FAQs — Centers for Medicare & Medicaid Services, read September 7, 2026
- 42 CFR Part 457: State Children’s Health Insurance Program (substitution of coverage, cost sharing) — eCFR, read September 7, 2026