Child Health Plus

To provide comprehensive health care services to uninsured children not eligible for Medicaid.

Eligibility

• Children, under age 19, who are New York State residents;
• Must not be eligible for Medicaid;
• Must have no other health insurance;
• Public employees who have access to family coverage through a state health benefits plan are not eligible.
• The following documents are required to enroll: proof of age; citizenship/ identity; NYS residency; household income. In some cases, proof of immigration status is required.

Description

Child Health Plus provides children under 19 with free or affordable health coverage depending on their household income. Coverage is available state-wide through 18 Child Health Plus health plans. Children enroll in one of the approved plans in the county where they live. Some of the services Child Health Plus covers are:

• Well-child care.
• Immunizations.
• Treatment for illness or injury.
• Inpatient hospital medical or surgical care.
• Short-term physical therapy; occupational therapy.
• Radiation therapy.
• Therapeutic outpatient services (chemotherapy, hemodialysis).
• Inpatient and outpatient treatment for alcoholism and substance abuse, and mental health.
• Prescription and non-prescription drugs if ordered by a physician.
• Emergency care.
• Emergency ground transportation.
• Emergency, preventative and routine dental care. Limited orthodontic services are available for children with a severe medical condition such as cleft lip or cleft palate.
• Preventive and routine vision care (including eyeglasses).
• Speech and hearing services (with limits).
• Durable medical equipment.
• Hospice services.

There is no monthly premium for families whose income is less than 1.6 times the poverty level. In 2013, that's about $600 a week for a three-person family, about $724 a week for a family of four. Families with higher incomes pay monthly premiums ranging from $9 to $60 a month per child, depending on their income and family size. For larger families, the monthly fee is capped at three children. If the family's income is more than 4 times the poverty level, they pay the full monthly premium charged by the health plan. There are no co-payments for services under Child Health Plus, so you don't pay anything when your child receives care through these plans.

Help with Signing Up

If you would like someone to assist you in applying for Child Health Plus, there are enrollers in your community who can help. These enrollers will help you complete the application, collect the necessary documents, and select a health plan. In many cases, assistance is available during evenings and weekends.

For More Information

For the nearest location where application assistance is available, or for more information, please call the NYS Health Department's CHPlus hotline 1-800-698-4543. If you have challenges with hearing or speech, call the TTY number, 1-877-898-5849.

Publication 0548
Revised 10/2013