Health Insurance for Children and Kids in 2026

Option 1: Medicaid for Children

Medicaid covers more children than any other program in the United States. All 50 states cover children up to at least 100% of the 2026 Federal Poverty Level (FPL). In the 40 states plus D.C. that expanded Medicaid under the ACA, children in families up to 138% FPL qualify automatically. In 2026 that threshold is $22,025 for a household of one and $45,540 for a household of four. Many states set separate, higher thresholds specifically for children. For example, most states cover children up to at least 200% FPL under Medicaid separate child eligibility categories, and some go as high as 317%. Contact your state Medicaid agency at InsureKidsNow.gov to confirm your state's specific child income limit.

Medicaid for children includes the EPSDT (Early and Periodic Screening, Diagnostic, and Treatment) benefit, which requires states to cover any service that is medically necessary for children under 21, even if that service is not otherwise included in the state's Medicaid plan. EPSDT covers well-child exams on a recommended schedule, immunizations, vision screening and glasses, dental exams and treatment, hearing screening and aids, and mental health services. Dependent children enrolled in Medicaid keep their coverage for a full 12 months regardless of income changes mid-year, under the mandatory continuous eligibility rule that took effect January 1, 2024 (Section 5112 of the Consolidated Appropriations Act, 2023).

Option 2: CHIP (Children's Health Insurance Program)

CHIP fills the gap between Medicaid and private insurance. Families whose income puts them above the Medicaid child threshold but below the CHIP ceiling (typically 200% to 317% FPL depending on the state) can enroll their children in CHIP for little to no monthly premium. In 2026, 200% FPL is $31,920 for a household of one and $66,000 for a household of four. Premiums are capped federally at 5% of household income and are often $0 to $50 per month. Copays are minimal (usually $1 to $5 per visit). CHIP is a separate state-administered program that runs parallel to Medicaid, and each state gives it a distinct brand name: Kentucky's program is KCHIP, Florida's is Florida KidCare, Texas's is the Children's Medicaid STAR program, and Illinois uses AllKids under the CHIP umbrella.

Under the CAA 2023 continuous eligibility mandate, minor children enrolled in CHIP also retain coverage for a full 12-month period even if family income rises above the CHIP threshold during the year. The only exceptions that end coverage early are the child turning 19 (or the state's CHIP upper age limit), the child moving out of state, or the child gaining Medicaid eligibility. CHIP plans must cover the same essential health benefit categories as ACA Marketplace plans, including dental, vision, mental health, and preventive services for children. Families apply through the same portal as Medicaid in most states at InsureKidsNow.gov or HealthCare.gov.

Option 3: Parent's Employer Plan

ACA Section 2714 requires employer-sponsored health plans to allow dependent children to remain on a parent's plan until age 26, regardless of the child's marital status, student enrollment, financial dependence, or living situation. When a minor child is born or adopted, the employing parent typically has 30 to 60 days (check the plan documents) to add the child without waiting for the next open enrollment. Missing that window means waiting until the employer's next open enrollment period unless another qualifying life event occurs. Employer plans that cover children must include pediatric dental and vision as part of the essential health benefits requirement.

Option 4: ACA Marketplace Family Plan with Subsidies

Families with children who earn above the CHIP ceiling but below 400% of the 2026 FPL (which is $132,000 for a family of four) may qualify for Premium Tax Credit subsidies on Marketplace family plans. The Premium Tax Credit (PTC) is calculated based on household size, income, and the benchmark Silver plan cost in the family's rating area. Families who have already enrolled their minor children in Medicaid or CHIP can still purchase a Marketplace plan just for the adults, paying only the adult-portion premium and receiving the PTC on the full family benchmark calculation. The 2026 subsidy cliff returned January 1, 2026 when enhanced PTCs from ARPA/IRA expired. Subsidies phase down as income approaches 400% FPL and stop at 400%. Above that line, families pay the full unsubsidized premium for a Marketplace plan.

All ACA Marketplace plans must cover children with no cost sharing for preventive services under USPSTF grade A or B recommendations, including annual well-child visits, developmental screening, vision screening, immunizations, and lead blood level testing. Pediatric dental and vision are required essential health benefits on Marketplace plans, though dental may be offered as a separate add-on plan in some states. The out-of-pocket maximum on Marketplace plans in 2026 is $10,600 for self-only and $21,200 for family coverage. A family with multiple children on a Marketplace plan hits the family out-of-pocket cap, after which all covered services are paid at 100% for the rest of the plan year.

Medicaid and CHIP income limits for children by household size in 2026

Children in the United States have the most generous public coverage thresholds of any age group. The table below shows the 2026 federal thresholds at 138% FPL (the Medicaid expansion floor for adults in expansion states) and 200% FPL (the federal CHIP minimum floor). States may and often do set child-specific Medicaid thresholds well above 138% FPL, and many states set CHIP ceilings at 250%, 300%, or 317% FPL. Use the table to gauge whether Medicaid or CHIP is likely available for your minor child; then verify the exact state limit at InsureKidsNow.gov or your state Medicaid agency.

Premium Tax Credit (PTC) eligibility for children's family plans in 2026

Families with children who earn above the CHIP ceiling in their state but below 400% of the 2026 FPL may qualify for Premium Tax Credits on an ACA Marketplace family plan. For a family of four, the 400% FPL threshold in 2026 is $132,000 in annual MAGI. Subsidies phase down as income approaches that ceiling and stop entirely at 400%. The enhanced PTCs that expanded eligibility from 2021 through 2025 under the American Rescue Plan Act and Inflation Reduction Act expired on January 1, 2026. Families projecting 2026 income should use the current subsidy structure, not the 2025 one, when planning coverage.

One important nuance for families with minor children on Medicaid or CHIP: when children are enrolled in Medicaid or CHIP, the family may still be eligible for PTC on a Marketplace plan covering the adults. The household size used to calculate the PTC still includes the children, even though the children are on a different program. This lowers the calculated premium contribution and often increases the subsidy for the adult-only Marketplace plan. Families reconcile the PTC with the IRS using Form 1095-A at tax time. Form 7206 does not apply to families with children unless a parent has self-employment income.

• 138% FPL (2026): Medicaid expansion floor for adults; many states cover children at a higher threshold
• 200% FPL (2026): federal CHIP minimum floor ($66,000 for a family of four)
• 250% FPL (2026): threshold where cost-sharing reductions (CSRs) on Silver plans are strongest
• 400% FPL (2026): PTC subsidy cliff, $132,000 for a family of four; subsidies stop here

12-month continuous eligibility and newborn auto-enrollment in 2026

Two federal rules dramatically strengthen coverage stability for minor children. First, newborns delivered by a mother covered by Medicaid are automatically deemed eligible for Medicaid for at least 60 days from birth with no separate application. Many states have extended this auto-enrollment period to 12 months. Parents whose household income is above Medicaid thresholds should still add the newborn to their employer plan or Marketplace plan within the plan's notification window (typically 30 to 60 days), because the 60-day Medicaid auto-enrollment is a safety net, not a substitute for appropriate long-term coverage.

Second, under Section 5112 of the Consolidated Appropriations Act, 2023 (CAA 2023), all states must provide 12 months of continuous eligibility for children under 19 enrolled in Medicaid or CHIP. This rule became mandatory January 1, 2024. It means that if a family enrolls a minor child in Medicaid in January 2026 and then receives a raise in May 2026 that would otherwise disqualify the child, the child keeps Medicaid through December 2026. The only early-termination exceptions are the child turning 19, leaving the state, or transitioning into Medicaid from CHIP. This rule eliminated annual paperwork churning that previously caused hundreds of thousands of children to lose coverage temporarily despite remaining eligible.

HSA and HDHP fit for children and family plans in 2026

Families with children who are enrolled in an HSA-qualified High-Deductible Health Plan (HDHP) can open a Health Savings Account (HSA) and use it to pay for qualified medical expenses for the whole family, including children, tax-free. In 2026 the HDHP minimum deductible for family coverage is $3,400 (Rev. Proc. 2025-19). The HSA family contribution limit in 2026 is $8,750 (plus a $1,000 catch-up if the account holder is 55 or older). HSA contributions reduce the family's MAGI, which can help stay below PTC eligibility thresholds. The triple tax advantage applies: contributions are tax-deductible, growth is tax-free, and withdrawals for qualified medical expenses (including children's copays, dental, and glasses) are tax-free.

Flexible Spending Accounts (FSAs) are an employer-sponsored alternative to HSAs. Unlike an HSA, an FSA does not require an HDHP pairing and can be used alongside any employer plan that includes dependent children. The 2026 FSA healthcare contribution limit is $3,400 per employee. FSA dollars are use-it-or-lose-it within the plan year (with a modest grace period or rollover depending on the employer), making them better suited to predictable child health expenses like annual eye exams, glasses, and orthodontia. Parents in families where children are on Medicaid or CHIP and the adults are on an employer plan can still use an FSA for the adults' out-of-pocket expenses. Note that FSA is employer-only, and families without employer coverage have no FSA access.

Catastrophic plans and children's coverage options in 2026

Catastrophic Marketplace plans are not an appropriate coverage option for children and minor dependents. Catastrophic plan eligibility under ACA rules is restricted to adults under age 30 or adults who qualify for a hardship exemption. Children and minors are not the eligible enrollees for catastrophic plans; the catastrophic plan covers the adult household member who qualifies. For the adults enrolling in a catastrophic plan in 2026, the plan deductible is $10,600 (equal to the ACA out-of-pocket maximum), meaning almost all medical costs for the year fall on the enrollee until that cap is hit. For children in the household, Medicaid, CHIP, or a standard Bronze or Silver Marketplace family plan almost always provides better value.

Marketplace Special Enrollment Period (SEP) triggers for children's coverage in 2026

Children and their families can gain access to Marketplace coverage outside of the November-to-January open enrollment window through a Special Enrollment Period (SEP). The SEP window is typically 60 days from the qualifying event. Children covered by Medicaid or CHIP may enroll in a Marketplace plan during a 60-day window following a loss of Medicaid or CHIP eligibility. Families should note that gaining CHIP or Medicaid coverage is itself a qualifying event for leaving a Marketplace plan, meaning families can freely move children between programs as eligibility changes.

Medicaid and CHIP accept applications year-round with no open enrollment period. Families can apply for children any month of the year and receive coverage typically within days of an eligibility determination. This year-round availability makes Medicaid and CHIP the coverage-of-last-resort for uninsured children who have missed Marketplace open enrollment. The enrollment process starts at InsureKidsNow.gov (phone: 1-877-KIDS-NOW) or through HealthCare.gov, which routes families to the correct state program.

• Birth or adoption of a child: 60-day SEP window; newborn may also be auto-enrolled in Medicaid
• Loss of other health coverage (employer plan, Medicaid, CHIP, or COBRA): 60-day SEP window
• Marriage or divorce affecting household composition: 60-day SEP window
• Moving to a new state (Medicaid does not transfer; re-apply in the new state for children)
• Income change that causes children to lose or gain Medicaid or CHIP eligibility: 60-day SEP window
• Child turning 26 and aging off a parent's plan (SEP for the young adult, not the parent): 60-day window
• Medicaid and CHIP applications accepted year-round with no enrollment period restriction

How to enroll children in Medicaid, CHIP, or a Marketplace plan in 2026

Enrolling a child in Medicaid or CHIP is free and can be done any time of year. The federal starting point is InsureKidsNow.gov (phone: 1-877-KIDS-NOW, M-F 8am-8pm ET). Most states also accept applications through HealthCare.gov, which routes the applicant to the correct state program. The application takes 10 to 20 minutes online. Coverage typically begins within a few days to a few weeks of the eligibility determination. Common reasons applications get delayed or denied include missing documentation, unreported income sources, or errors in household composition.

• Step 1: Go to InsureKidsNow.gov or HealthCare.gov and select your state. Medicaid and CHIP accept applications year-round.
• Step 2: Gather documents needed: proof of child's age (birth certificate or hospital record), proof of state residency (utility bill, lease), proof of household income (pay stubs, tax return, or W-2s), Social Security numbers for household members, and immigration documents if applicable.
• Step 3: Submit the application online, by phone, by mail, or in person at your state Medicaid office. Online is typically fastest.
• Step 4: Receive an eligibility determination, usually within 45 days (or 90 days if disability-based). For children, many states process within 2 to 5 business days.
• Step 5: If the child does not qualify for Medicaid or CHIP, the state will refer you to Marketplace options. You may have a 60-day SEP window to enroll in a Marketplace plan if you received a denial because of income.
• Common denial reasons: income above state CHIP ceiling (use the screener to verify), child already covered under another plan (must disenroll first), incomplete documentation, or household composition discrepancy between application and records.

What is the cheapest health insurance for children and kids in 2026?

For most families, Medicaid or CHIP is the cheapest option for children and kids in 2026. Medicaid is free (no premiums, minimal or no copays) for families up to 138% FPL in expansion states, and often higher thresholds just for children. CHIP typically costs $0 to $50 per month for families between the Medicaid ceiling and 200% to 317% FPL depending on the state. A family of four earning up to $66,000 (200% FPL) likely qualifies for CHIP in most states. Use the screener or visit InsureKidsNow.gov to check your state's exact limits.

Does my child qualify for Medicaid or CHIP in 2026?

Eligibility for Medicaid and CHIP depends on your state, your household size, and your family's gross income. Most states cover children in families earning up to 200% FPL under Medicaid or CHIP, and some states cover children in families earning up to 317% FPL. In 2026, 200% FPL is $31,920 for a single person and $66,000 for a family of four. The 12-month continuous eligibility rule (mandatory since January 2024 under the CAA 2023) means that once enrolled, minor children stay covered for a full year even if income rises. Apply free at InsureKidsNow.gov or HealthCare.gov.

Do children qualify for the Premium Tax Credit on an ACA Marketplace plan?

The Premium Tax Credit (PTC) applies to the family's Marketplace plan, not to individual children separately. If the family's MAGI is between 100% and 400% FPL in 2026, the PTC reduces the family's monthly premium. Children enrolled in Medicaid or CHIP are excluded from the Marketplace plan but are still counted in the household size for PTC calculation purposes, which can increase the subsidy for the adults. Families reconcile PTC using Form 1095-A at tax time. The subsidy cliff returned January 1, 2026, meaning families at or above 400% FPL ($132,000 for a family of four) receive no subsidy.

Can a child's health insurance cover dental and vision in 2026?

Medicaid's EPSDT benefit covers dental exams, dental treatment, vision screening, and glasses for children under 21 at no cost. All ACA Marketplace plans must include pediatric dental and vision as essential health benefits, though dental may be sold as a separate add-on plan in some states. CHIP also covers dental and vision. Employer-sponsored plans that include dependent children must cover pediatric dental and vision as essential health benefits under ACA rules. If your child is on a parent's plan, verify that the plan includes pediatric dental or offers a dental add-on.

Can a child use an HSA or FSA for medical expenses in 2026?

HSA funds can be used for any IRS-qualified medical expense for anyone in the household, including dependent children. The family can use the HSA to pay for children's deductibles, copays, prescriptions, dental work, and vision expenses tax-free. The family HDHP must have a minimum deductible of $3,400 in 2026, and the family HSA contribution limit is $8,750. A Flexible Spending Account (FSA) is employer-sponsored and can also be used for children's medical expenses. FSAs are employer-only, so families without employer coverage have no FSA access. Form 7206 does not apply to children since children have no self-employment income.

When can I enroll my child in a Marketplace plan outside open enrollment?

Families can trigger a 60-day Special Enrollment Period (SEP) for a Marketplace plan through any of these events: birth or adoption of a child, loss of other health coverage (employer plan, Medicaid, CHIP, or COBRA), marriage or divorce affecting household composition, moving to a new state, or an income change that causes children to lose Medicaid or CHIP eligibility. Medicaid and CHIP accept applications year-round with no enrollment period, making them available to uninsured children at any time. After enrolling a child in Medicaid or CHIP, the family has a 60-day window to leave any current Marketplace plan if preferred.

What is the 12-month continuous eligibility rule for children in Medicaid and CHIP?

Under Section 5112 of the Consolidated Appropriations Act, 2023 (CAA 2023), all states must provide 12 months of continuous eligibility for children under 19 enrolled in Medicaid or CHIP. This rule became mandatory January 1, 2024. If a family enrolls a child in Medicaid in January 2026 and the family's income rises to above the Medicaid threshold in May 2026, the child keeps Medicaid through December 2026. The rule eliminates mid-year paperwork churn that previously caused children to lose coverage despite remaining eligible. The only exceptions are the child turning 19, moving out of state, or gaining Medicaid while enrolled in CHIP.

Are immigrant children covered by Medicaid or CHIP in 2026?

Lawfully present immigrant children are generally eligible for Medicaid and CHIP under federal law after a 5-year waiting period, though many states have waived the waiting period for children. California (Medi-Cal), New York, Illinois (AllKids), Oregon (Oregon Health Plan), Washington (Apple Health), Massachusetts (MassHealth), and Washington D.C. cover children regardless of immigration status, including undocumented children, using state-funded programs. In all other states, undocumented children may still receive emergency Medicaid for acute care. CHIP perinatal programs in some states cover unborn children through coverage of pregnant women regardless of status.