Medicaid Office

Utah CHIP: Children's Health Insurance Program

Updated August 2026

Utah's Children's Health Insurance Program (CHIP) provides coverage for uninsured children from birth through age 18 in families with income above standard Medicaid income thresholds but below the CHIP ceiling. Utah operates CHIP as a separate CHIP — distinct from Medicaid — meaning children in the CHIP income tier may have slightly different benefits or cost-sharing than children in the lower-income Medicaid tier. The application process is the same.

5%

Annual cost-sharing cap (of family income)

60 days

Special enrollment window after losing other coverage

Year-round

Enrollment period

One application screens for both Utah Medicaid and CHIP

The single application at jobs.utah.gov/mycase simultaneously screens for both Utah Medicaid and CHIP eligibility — families don't need to determine in advance which program their child qualifies for.

Utah's CHIP program for children

Utah CHIP provides comprehensive health benefits including physical health, dental, vision, behavioral health, prescriptions, and preventive care. Children in CHIP may have small co-pays for some services and a monthly premium at higher income levels, though both are capped per federal CHIP cost-sharing rules (5% of family income annually).

CHIP income eligibility and premiums

Utah CHIP covers children in families with income above standard Medicaid thresholds — approximately up to 200% FPL for children's Medicaid, with CHIP extending coverage at higher income levels. Income limits update annually. Source: Utah CHIP income guidelines, effective March 2026 (chip.utah.gov/faqs).

2 (single parent & one child)

Monthly income limit
$3,607
Annual income limit
$43,284

3

Monthly income limit
$4,554
Annual income limit
$54,648

4

Monthly income limit
$5,500
Annual income limit
$66,600

5

Monthly income limit
$6,447
Annual income limit
$77,364

6

Monthly income limit
$7,394
Annual income limit
$88,728

7

Monthly income limit
$8,340
Annual income limit
$100,080

8

Monthly income limit
$9,287
Annual income limit
$111,444

CHIP families contribute through co-pays rather than a flat monthly premium in most cases. Federal CHIP rules cap total annual out-of-pocket costs (co-pays and deductibles combined) at 5% of family income per benefit year. American Indian and Alaska Native children, and families with no income in the benefit year, do not pay co-pays. Call 1-877-KIDS-NOW (1-877-543-7669) or visit chip.utah.gov for the current co-pay summary.

What Utah CHIP covers for children

Children in Utah CHIP receive comprehensive coverage. CHIP benefits for members under age 21 are governed by the federal EPSDT mandate (42 U.S.C. § 1396d(r)) for services crossing into Medicaid, and state-defined benefits for the CHIP tier.

  • Well-child visits and preventive screenings at no additional cost
  • Immunizations per the CDC schedule
  • Vision — eye exams and eyeglasses
  • Dental — comprehensive pediatric dental coverage
  • Hearing screenings and hearing aids when medically necessary
  • Mental and behavioral health services
  • Prescription medications
  • Hospital care, specialist visits, and laboratory services
  • Physical, occupational, and speech therapy

Enrolling a child in Utah CHIP or Medicaid

Apply any time — Utah Medicaid and CHIP enrollment is year-round. A child who loses employer-sponsored coverage has a special enrollment window; apply within 60 days of losing coverage. Newborns born to Utah Medicaid-enrolled mothers are automatically enrolled in Medicaid from birth.

Children enrolled in Utah Medicaid or CHIP in the Wasatch Front region (Salt Lake, Utah, Davis, Weber, and Iron counties) may be enrolled in Utah Medicaid Integrated Care (UMIC) managed care. UMIC members are assigned to a primary care provider. Outside those counties, children are covered through fee-for-service Utah Medicaid and can see any enrolled provider directly.

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 Utah CHIP

Apply through Utah Medicaid — the same application covers both Medicaid and CHIP. Online applications are typically fastest and allow document uploads. You can also apply by phone or in person at a local eligibility office.

If you're not sure whether your child qualifies for Medicaid or CHIP, apply anyway. The eligibility system determines which program applies based on your income. A child who earns out of Medicaid may qualify for CHIP, and vice versa.

Utah Medicaid

  • Apply for Utah Medicaid and CHIP: jobs.utah.gov/mycase
  • Utah CHIP phone line (1-877-KIDS-NOW): 1-877-543-7669
  • Utah Medicaid: medicaid.utah.gov
Visit the official Utah Medicaid website

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