Aging off CHIP surprises many families because the Children's Health Insurance Program stops at age 19 in every state, and the end date often arrives with a single notice from the state agency. Most states end CHIP on the last day of the month of the 19th birthday, though a few use the birthday itself. Federal rules treat the loss as a qualifying life event, so the Marketplace gives your family a Special Enrollment Period (SEP) of 60 days after the end date. The Marketplace also lets you apply up to 60 days before, which is the single best way to avoid an uninsured month. The transition path in 2026 follows a fixed order: Medicaid first, because it is free and open year-round; a parent's employer plan second, because dependents can stay on until age 26; then a Marketplace plan with premium tax credits at healthcare.gov. State programs carry local names such as Medi-Cal, AllKids, BadgerCare Plus, CHP+, NJ FamilyCare, and MassHealth, but the federal rules behind them are the same.
Income decides most of the outcome. The 2026 Federal Poverty Level (FPL) is $15,960 for one person and $33,000 for a family of 4, and the 138% FPL Medicaid line for adults in the 40 expansion states plus DC is $22,025 for one person in 2026. A 19-year-old who is still claimed as a tax dependent usually counts inside the parents' household for both Medicaid and Marketplace purposes, so the family's total projected 2026 income, not the teenager's paycheck, drives the answer. Families above 400% FPL ($63,840 for one person, $132,000 for 4 in 2026) get no premium tax credit because the subsidy cliff returned on January 1, 2026 when the enhanced credits expired. The steps below walk through the order of operations, the documents you need, the state differences that matter, and the mistakes that leave young adults uninsured. Use the Medicaid income limits and ACA income limits pages to check your household size before you apply.
7 Steps to Get Coverage
Common Mistakes That Cost People Thousands
The most expensive mistakes families make when a child ages off CHIP in 2026:
- Waiting until CHIP ends to apply. The Marketplace SEP opens 60 days before the end date, and applying early avoids a gap month.
- Skipping Medicaid. A household under 138% FPL in 2026 qualifies for free coverage, and Medicaid has no SEP deadline.
- Using the 19-year-old's own paycheck as household income. A tax dependent usually counts inside the parents' household, so the family's projected 2026 income decides eligibility.
- Overlooking the parent's employer plan. Dependents stay eligible to age 26, and employer plans must open a 60-day window after a child loses CHIP.
- Ignoring Form 1095-A at tax time. Skipping Form 8962 can cost the premium tax credit for the next year.
Medicaid Eligibility After Aging Off CHIP in 2026
Medicaid is the first stop after CHIP in 2026 because adults 19 to 64 qualify at 138% FPL in the 40 expansion states plus DC, which is $22,025 for a single person and $45,540 for a family of 4 in 2026. State programs go by local brands: Medi-Cal in California, AllKids and Illinois Medicaid, BadgerCare Plus in Wisconsin, MassHealth in Massachusetts, NJ FamilyCare in New Jersey, HUSKY Health in Connecticut, Apple Health in Washington, and Med-QUEST in Hawaii. Apply through your state Medicaid agency or healthcare.gov, and the application is shared across agencies. Medicaid enrollment is year-round per medicaid.gov, so no 60-day clock applies. Federal law enacted in 2025 adds work or community engagement requirements for many expansion adults ages 19 to 64 no later than January 1, 2027, with exemptions that vary by state, so check your state agency for the rules that apply to a student or young worker.
State Differences After CHIP in 2026: Expansion vs Non-Expansion States
Expansion status changes the path more than any other state variable. Forty states plus DC have expanded Medicaid, so a young adult in those states with income under 138% FPL in 2026 moves from CHIP straight into adult Medicaid. Ten states have not expanded: Alabama, Florida, Georgia, Kansas, Mississippi, South Carolina, Tennessee, Texas, Wisconsin, and Wyoming. In those states, most adults without dependent children do not qualify for Medicaid at any income, and Wisconsin's BadgerCare Plus is the exception that reaches 100% FPL. The Marketplace fills the gap with premium tax credits starting at 100% FPL, which is $15,960 for one person in 2026. Below 100% FPL in a non-expansion state, a young adult may fall into the coverage gap with no subsidy and no Medicaid. Former foster youth are a special case: federal law gives Medicaid until age 26 to young adults who were in foster care at 18, regardless of income, in every state.
Avoiding a Coverage Gap When CHIP Ends in 2026
Timing decides whether a young adult has a gap month. A Marketplace plan selected before CHIP ends starts the first day of the month after the end date, so a child who loses CHIP on June 30, 2026 starts the new plan on July 1, 2026 with no gap. A plan selected after CHIP ends starts the first day of the month after the plan selection, which leaves a gap of up to a month. Medicaid follows state rules: applications are processed within weeks, and some states grant retroactive coverage for recent medical bills, though federal law shortens that retroactive window starting in 2027. Medicaid.gov and your state agency list the current rule. Start every application at least 30 days before the CHIP end date, keep the termination notice, and confirm the start date in writing so the first claim goes through. Schedule routine care, refills, and any dental or vision visits before the old coverage ends, because the first weeks on a new plan often involve ID card delays.
Frequently Asked Questions
What is the SEP window for aging off CHIP?
Aging off CHIP triggers a 60-day Special Enrollment Period at healthcare.gov, and you can apply up to 60 days before the coverage end date. Example: if CHIP ends June 30, 2026, your Marketplace SEP runs May 1, 2026 through August 29, 2026. Enroll before the end date and the new plan starts the first day of the next month. Enroll after and coverage starts the first day of the month following your plan selection. Medicaid has no deadline, and a parent's employer plan must open a 60-day special enrollment window under CHIPRA when a child loses CHIP.
How do I document aging off CHIP for a Marketplace application?
Keep the CHIP termination or age-out notice from your state agency, because it proves the qualifying life event and the exact end date. The Marketplace may ask you to upload it within 30 days of the application. Also gather Social Security numbers, recent pay stubs or a 2026 income estimate, the young adult's tax dependent status, and your address. If you lost the notice, log in to your state CHIP or Medicaid account and download the coverage history, or call the state agency for a letter.
What if I miss the 60-day SEP window after CHIP ends?
Missing the 60-day Marketplace SEP usually means waiting until Open Enrollment, which runs November 1, 2026 through January 15, 2027 for 2027 coverage, and going uninsured until then. You may still qualify if another qualifying life event occurs, such as moving or marriage. Medicaid is the exception: enrollment is year-round, so a young adult under 138% FPL in an expansion state can apply any day. Ask the Marketplace about a good-cause exception if illness or a state error caused the delay.
Can I get retroactive coverage after CHIP ends?
Marketplace plans are not retroactive: coverage starts the first day of the month after plan selection, or after the CHIP end date if you enroll early. Medicaid may be different, since some states cover medical bills incurred in the months before the application date if you were eligible then. Federal law enacted in 2025 shortens that retroactive window beginning in 2027, so confirm the current rule with your state Medicaid agency. Applying before CHIP ends is the safest way to avoid depending on retroactive coverage.
What is the difference between COBRA and Marketplace after CHIP?
COBRA continues an employer plan you already had, at 102% of the full premium in 2026, so it rarely applies after CHIP because a child on CHIP did not hold employer coverage. If a parent's employer plan covered another family member, the young adult can usually join that plan within 60 days as a dependent until age 26. A Marketplace plan with premium tax credits, roughly 2% to 10% of income for a benchmark Silver plan in 2026, is the usual choice for households above Medicaid limits.
What state-specific rules apply when a child ages off CHIP?
State rules decide the CHIP end date and the next program. CHIP ends at age 19 everywhere, but states choose whether it stops on the birthday or the last day of the birthday month. Expansion states such as California (Medi-Cal), Illinois (AllKids), Massachusetts (MassHealth), and Colorado (CHP+) move adults under 138% FPL to Medicaid. Non-expansion states such as Texas and Wisconsin (BadgerCare Plus covers adults to 100% FPL) send most young adults to the Marketplace. Check your state agency for the exact date.
Do I qualify for Medicaid after my child ages off CHIP?
You qualify in an expansion state if household income is under 138% FPL, which is $22,025 for one person and $45,540 for a family of 4 in 2026 (see the household size table). A 19-year-old claimed as a tax dependent counts in the parents' household, so the family's total projected 2026 income decides the outcome. In the 10 non-expansion states, most adults without dependent children do not qualify at any income. Apply year-round through your state agency or healthcare.gov to get a determination.
What happens to my younger children's coverage when one child ages off CHIP?
Younger children stay on CHIP or Medicaid as long as they meet the age and income rules of your state, which commonly reach 200% to 300% FPL in 2026. Only the child who turns 19 loses coverage. Each child is evaluated separately, so one family can have a sibling on CHIP, a young adult on Medicaid or a Marketplace plan, and parents on employer coverage. Report the household change to your state agency so the siblings' renewals use the correct household size.
