District of Columbia CHIP: Children's Health Insurance Program
Updated August 2026
DC uses its full Medicaid program to cover children, rather than maintaining a separate CHIP program with distinct branding, benefits, or administration. DC funds children's coverage above the federal Medicaid floor using CHIP Title XXI funds — but from the member's perspective, it is all "DC Medicaid" through DC Healthy Families.
319% FPL
DC children's Medicaid (CHIP-funded) income limit
DC Healthy Families
DC's integrated Medicaid/CHIP program
(202) 727-5355
DHS IMA Service Center phone
DC does not have a separate CHIP program
DC integrates children's coverage fully into DC Medicaid. There is no separately branded CHIP program. Children up to age 18 (and pregnant women) qualify for DC Healthy Families (managed care Medicaid) at household incomes up to 319% FPL, funded partly through CHIP Title XXI dollars; children ages 19–20 qualify at a lower 216% FPL limit. The same application covers adults and children.
How DC covers children — fully integrated with Medicaid
This integration means there is no gap between Medicaid and CHIP benefits, no separate enrollment process, and no different managed care plans at different income levels. Children up to 319% FPL receive the same comprehensive DC Medicaid benefit package regardless of whether their coverage is technically funded through Medicaid or CHIP dollars.
Who qualifies for children's coverage in DC
Children qualify for DC Healthy Families coverage under the following criteria.
- Children up to age 18, or pregnant women: household income at or below 319% FPL — about $8,683/month (roughly $104,196/year) for a family of four, per the DC Healthy Families FPL chart
- Children ages 19–20: a lower household income limit applies — at or below 216% FPL, per DC Healthy Families
- Must be a DC resident
- Must be a U.S. citizen or qualifying immigrant
- No separate CHIP application — one DHS application covers all income levels
Benefits for children in DC Healthy Families
DC Medicaid/DC Healthy Families provides comprehensive coverage for enrolled children, including dental and vision as explicitly listed benefits. Children receive EPSDT-scope dental care, which covers all medically necessary dental services.
- Well-child and preventive care visits
- Immunizations
- Doctor visits and specialist referrals
- Emergency and urgent care
- Inpatient hospital care
- Prescriptions
- Dental care (comprehensive EPSDT scope)
- Eye care and vision services
- Mental health and substance use treatment
- Physical, occupational, and speech therapy
- Home and community-based services when medically necessary
- Non-emergency medical transportation
DC children's coverage compared to other jurisdictions
At 319% FPL, DC's children's coverage threshold is among the highest in the country — comparable to Vermont's Dr. Dynasaur (312% FPL). A family of four earning up to about $104,196 per year (per the DC Healthy Families FPL chart) qualifies children up to age 18 for DC Medicaid, while 19- and 20-year-olds qualify at a lower 216% FPL limit. This reflects DC's policy of near-universal coverage for children and its ability to use CHIP funds to extend coverage well above the standard Medicaid floor.
What CHIP is
CHIP — the Children's Health Insurance Program — is a federal-state partnership that covers children in families whose income is too high for Medicaid but too low to afford private insurance. Congress created CHIP in 1997 under Title XXI of the Social Security Act. Like Medicaid, CHIP is jointly funded by the federal government and each state, and each state administers its own program.
CHIP serves children up to age 19 (some states cover to 21 for children in foster care). It is not available to adults — CHIP is specifically designed to address the coverage gap for children in working families.
Nationally, CHIP covers approximately 7 million children, according to CMS data. In most states, it is a seamless part of the broader children's health coverage system alongside Medicaid.
How to apply for DC children's coverage
Apply through a DHS IMA Service Center or call (202) 727-5355. The same application covers adults and children — DC Healthy Families is administered as part of DC Medicaid.
DC Medicaid
- DHS IMA Service Center phone: (202) 727-5355
- DC Medicaid (DHCF): dhcf.dc.gov/service/medicaid
Related guides
For Pregnant Women
Coverage, income rules, and postpartum benefits during pregnancy.
Read more →Eligibility Requirements
The income, household, age, and state rules that determine who qualifies.
Read more →What Medicaid Covers
The services every state must cover, plus benefits that vary by state.
Read more →