Child health

This page is for families in the U.S. who want to arrange their child's health insurance and vaccinations. We explain CHIP and Medicaid, preventive services covered free of charge by insurance, the vaccination schedule changes in 2025–2026, vaccinations required for school, and the free vaccination program. For Medicaid and CHIP rules according to immigration status, see 16.3 Medicaid and CHIP.

• Employer-sponsored insurance: You can add your child within at least 30 days after birth or adoption.
• HealthCare.gov (Marketplace): During the open enrollment period or within 60 days of special circumstances such as birth.
• Medicaid: Free or low-cost insurance for children in low-income families.
• CHIP: Low-cost insurance for children in families whose income exceeds the Medicaid limit.
• A child born in the U.S. is a U.S. citizen. Even if their parents are not eligible, the child can apply for Medicaid or CHIP as a citizen.
• Insurance steps for a newborn: see 8.2 Birth expenses.

• CHIP is a joint program of the federal government and the states. It covers children under age 19.
• Each state determines who is eligible.
• You can apply in any month of the year. If eligible, coverage may begin immediately.
• When you apply to your state's Medicaid agency, your child's eligibility for CHIP will also be evaluated.
• Some states charge monthly premiums. The total cost of CHIP cannot exceed 5% of the family's annual income.
• Well-child checkups and dental checkups are free. There may be copayments for other services.
• Application: your state's Medicaid agency, HealthCare.gov, or +1 800 318 2596 (TTY: +1 855 889 4325).

• Most health plans must cover a range of preventive services for children free of charge. This includes Marketplace plans and Medicaid.
• If the service is obtained from an in-network doctor, you generally do not pay a copayment, even if you have not met your deductible.
• Some of these services include:
  • hearing screening, blood screening, bilirubin screening, and hypothyroidism screening for newborns
  • developmental screening under age 3; autism screening at 18 and 24 months
  • regular height, weight, and body mass index measurements
  • fluoride varnish application after teeth erupt
  • depression screening for adolescents starting at age 12
  • vaccinations from birth through age 18
• Children on Medicaid: Children under age 21 enrolled in Medicaid are entitled to regular screening, diagnosis, and treatment under EPSDT.

• In the U.S., the Centers for Disease Control and Prevention (CDC) publishes the childhood vaccination schedule. The schedule has changed over the past two years:
• December 16, 2025 – hepatitis B birth dose:
  • For babies whose mothers tested negative for hepatitis B, the birth dose is now left to a decision made jointly by the family and doctor.
  • If the mother's test is positive or unknown, the baby will continue to receive the vaccine within 12 hours of birth.
  • If the birth dose is postponed, starting the vaccine series at the earliest at 2 months of age is recommended.
• January 5, 2026 – schedule reorganization: The CDC divided vaccines into three groups:
  • recommended for all children: measles, mumps, rubella, polio, pertussis, tetanus, diphtheria, Hib, pneumococcal disease, HPV, and chickenpox
  • recommended for specific risk groups
  • vaccines decided jointly by the family and doctor (“shared clinical decision-making”)
• According to the CDC, all vaccines in the three groups will continue to be covered by insurance without copayments.
• The vaccination schedule is a controversial topic and may continue to change. Plan your child's vaccinations with your pediatrician and check the current schedule on the CDC website.

• Each state determines by law which vaccinations are required for enrollment in school and daycare.
• Example: New York State, 2026–27 school year
  • To attend school, a child must have vaccinations appropriate for their age.
  • The number of doses and the intervals between doses are evaluated according to the schedule of the U.S. Advisory Committee on Immunization Practices (ACIP). Doses given too early do not count.
  • Required vaccinations include diphtheria-tetanus-pertussis, polio, measles-mumps-rubella (MMR), hepatitis B, and chickenpox.
  • MenACWY is also required in grades 7–12, and Hib and pneumococcal vaccines are required in daycare and preschool.
  • For some diseases, proof of immunity through a blood test is accepted.
• For school enrollment, see 6.5 Children's school enrollment.

• VFC is a federal program that provides recommended vaccines free of charge to eligible children through age 18.
• The following children are eligible:
  • children eligible for Medicaid
  • children without health insurance
  • children whose insurance does not cover the vaccine and who receive the vaccine at a community health center (FQHC) or rural health clinic
  • American Indian and Alaska Native children
• A VFC-enrolled doctor cannot charge for the vaccine itself. The doctor may charge an administration fee but cannot refuse the vaccine because you cannot pay.
• Ask your child's doctor whether they are enrolled in VFC.
• CDC information line: +1 800 232 4636

• Bring documentation of vaccinations received in Türkiye (a vaccination card or immunization record). The school and doctor will request this record.
• Missing doses are completed according to the CDC catch-up schedule. Your doctor will decide which doses count.
• A child who does not submit the school vaccination record on time may be unable to attend school in some states. Ask your school before enrollment.
• For free or low-cost care at community health centers, see 16.6 Services accessible regardless of status.

• HealthCare.gov call center — CHIP, Medicaid, and Marketplace
  • Phone: +1 800 318 2596 (TTY: +1 855 889 4325), 24/7
• Your state's Medicaid and CHIP agency
  • Web: List of state agencies
• InsureKidsNow.gov — CHIP and Medicaid information for children
  • Web: insurekidsnow.gov
• CDC information line (CDC-INFO) — vaccines and VFC
  • Phone: +1 800 232 4636
• Community health centers (HRSA)
  • Web: Find a health center

• Not applying for CHIP for a child because you think, “Our income is too high.”
• Assuming that a child born in the U.S. cannot apply for Medicaid or CHIP because the parents are not eligible.
• Using a doctor outside the plan network for preventive checkups and having to pay.
• Failing to bring the vaccination record from Türkiye and having to repeat the vaccinations from the beginning.
• Looking only at the CDC schedule and not checking the state's school vaccination requirements.
• Not asking whether the pediatrician is enrolled in VFC.

• I work with an H-1B visa. Can my child born in the U.S. get CHIP? Because your child is a U.S. citizen, they can apply as a citizen. Eligibility depends on the family's income and the state's rules.
• How long does CHIP last? CHIP covers children under age 19.
• Do vaccines cost money? Most insurance plans cover recommended vaccines free of charge when provided by an in-network doctor. Children without insurance or eligible for Medicaid may receive free vaccines through the VFC program.
• Are hepatitis B vaccines no longer given? They are still given. Since the end of 2025, for babies whose mothers tested negative, the timing of the birth dose has been left to a decision by the family and doctor. Your state's school requirements still apply.
• Which vaccines does the school require? Check your state's health department's school vaccination list. The list is published for each school year.
• Are vaccinations received in Türkiye valid? Documented vaccinations are evaluated. Your doctor completes missing doses according to the catch-up schedule.

• HealthCare.gov eligibility check based on income
• State Medicaid and CHIP agencies
• List of preventive services for children (HealthCare.gov)
• CDC childhood and adolescent vaccination schedule
• CDC catch-up vaccination schedule
• New York 2026–27 school vaccination requirements (PDF)
• Vaccines for Children program (CDC)
• Find a community health center (HRSA)