Child Health Plus

What is Child Health Plus

Child Health Plus (CHP) is a NY health insurance program for children less than 19 years of age in New York State. This program is designed for individuals and families of children who do not qualify for Medicaid but cannot afford full premium coverage.

 

How to Enroll

Give us a call at our toll-free number, (888)215-4045 and we’ll help determine if you’re eligible. Then well compare all health insurance companies offering CHP in your area to ensure your current doctors, labs, and hospitals are all in the network.

Visit each Health Insurer to review their plans, but you won’t be able to do a side-by-side comparison between other insurers as each insurer may offer additional non-mandatory benefits.

Visit the New York State of Health as an enrollment option. Unfortunately, plans are not displayed online, which makes comparing and selecting the right plan more challenging.

 

What Does it Cost?

The monthly cost is determined by the family size and annual income. Please use the following chart to determine what you should expect to pay.

Are You Eligible?

 To be eligible. you must meet the following:

1. Residency Requirements 
2. Age Requirements

Residency Requirements

The family must be one of the following: U.S. citizens, permanent US residents, or those with a work visa. Non-U.S. citizens need to provide proof of residency with a copy of their alien resident card or work visa.

Proof of  New York State Residency is required and only the following are acceptable: a copy of your NY Drivers Licence or a NY Non-Driver ID Card.

Age Requirements

Only children below age 19 are qualified to get this program.

 

What Is Covered

Medical, Dental, and Vision Coverage

Extensive medical, dental, and vision coverage. Hearing services and vision services including exams and glasses.

Preventive Care

Checkups, well-child visits, and sick visits. Physical exams and immunizations (vaccines).

Hospital and Emergency Care

Inpatient hospital and surgical care. Urgent care, retail health clinic, and emergency room visits.

Diagnostic Services

Imaging services, including X-rays, and Lab tests.

Therapies

Both short-term and long-term physical, occupational, and speech therapy.

Prescription Drugs

Prescription and non-prescription drug coverage, with no copays for prescription drugs if ordered through a licensed professional.

Additional Services

Therapeutic outpatient services, including chemotherapy and hemodialysis. Programs for managing care to support ongoing health needs. Inpatient and outpatient mental health care.

 

Insurers Offering Child Health Plus

Affinity Health Plan

CDPHP

EmblemHealth

Excellus Blue Cross Blue Shield

Fidelis Care

Healthfirst

HealthNow Blue Cross Blue Shield of Western New York

Empire HP

Independent Health

MetroPlus Health

Molina Healthcare

MVP

United Healthcare

Univera Healthcare

 

2024 Child Health Plus Plan Map

The table below lists the availability of Child Health Plus in each New York county, ensuring that all eligible children have access to essential medical services regardless of where they live.

 

Eligible Enrollment Dates

There are no restrictions and you can enroll your child any time throughout the year. 

 

Frequently Asked Questions

What’s needed as proof of income?

When applying, you’ll need to provide any of the following: most recent tax return, payroll receipts, and if unemployed, then proof of your unemployment income. Those are the most commonly accepted.

What is the most my family can earn to qualify for CHP?

Unlike the essential plan there are no income limits, however, to qualify for reduced rates, please use the chart above to determine your monthly premium

What documents do I need when I apply?

You will need proof of citizenship, residency, and proof of income.

Can I sign up at any time?

Yes

Can my child still qualify if I’m unemployed?

Yes, though as proof of income, you’re going to need to provide Unemployment Benefit documentation.

Can a student be covered?

Yes, as long as they’re under 19.

Can I get CHP if I’m not a resident of New York?

No. New York State residency is required.

How long must we be NY residents to qualify?

There is no fixed duration. You’ll just need proof of residency status

What if im an immigrant, can my child still qualify? 

Yes especially if any of the following apply:

• You recently became a US citizen or your child has DACA status (Deferred Action for Childhood Arrivals)
• You’re a permanent resident legally in the county
• A lawfully present resident
• If your child has a valid student visa.

My child is covered under my health plan but my current income has fallen, can i cover my child under this plan?

Yes, though you will need to provide proof of your income and meet the residency requirements

I’m a freelancer and I don’t have a steady income.

You can still have your child qualify though you will need to prepare your most recent proof of income when you apply.

What is the start date?

1st day of the month.

My child has a health issue, can he still qualify?

Yes. Pre-existing conditions cannot be used to deny coverage

How long does it take to apply?

With our assistance, it usually takes an average 20 – 40 minutes

What information is needed to apply?

Your address is required as well as SSNs for all applying, proof of income and citizenship, and dates of birth are needed

My child is pregnant can they still qualify?

Yes, coverage cannot be denied because of pregnancy

What is covered under the plan?

All mandatory coverage is included as well as dental and vision care.

Can my employer pay for my child’s coverage?

No, you are responsible for any premiums due

My child is under 19 and employed, can they get covered?

Yes, as long as they meet the standard requirements of income and residency

I’m covered under an employee plan; can I take my child off and have them covered under Child Health plus

Yes, though keep in mind that the premium will be based on your income

What happens if during the year my household income changes?

Then you will need to contact the insurance company and inform them before the 15^th of the month to have the new premium take effect the following month

What if I need to cancel coverage, do I have to wait or can I cancel anytime?

You can cancel anytime through coverage continues till the end of the month

Can I backdate the start of coverage?

If you are not currently covered under another plan then yes, your start date will be retroactive to the beginning of the month. If you are covered under another plan, then your insurance will default to the 1^st of the following month.

Im not happy with the insurer I chose can I switch it at any time?

Yes, you can, as long as you still qualify for coverage

What if my doctor leaves the network?

You can select another doctor or choose a new plan

Im going to be moving out of New York, so I only need coverage for a few months, is that ok?

Yes not a problem though it’s advisable to make sure your new coverage starts when your old coverage ends

When will my plan expire and when do I renew my plan?

Your plan coverage is for 12 months. You’ll need to renew one month before your expiration date.

I didn’t pay my last premium, am I still covered?

Yes, just be sure to contact the health insurance company. All insurance plans have a 30-day grace period before cancellation

When should I receive my ID card?

In most cases about 7 – 10 days after your application has been submitted

I need to see a specialist do I need to get a referral?

Referrals are not needed.

Can I use any doctor or hospital of my choosing?

No, coverage is only for in-network unless you’re receiving emergency care

Are vision and dental included?

Yes though you should check what’s covered in the summary of benefits

I don’t have a doctor, must I select one when I apply

No. you don’t need to select a primary physician

What’s the difference between child Health Plus  Medicaid?

CHP has a higher income limit than Medicaid

What is the cost of the plan?

based on income, it can be free, or range from 15 dollars  a month to the full premium, which varies by insurer

How much are prescriptions?

All eligible prescriptions have a $0 copay

Is there a deductible?

The plan has a $0 deductible

What does it cost to use the plan?

The plan has a $0 copay

I need to see a specialist, what do I do?

No referral is necessary, just make an appointment with the specialist of your choosing. Keep in mind that any procedures or prescriptions ordered may require prior approval so check with your insurance company.

Is preventative care free?

Yes, all medical care is free.

I need a procedure, do I need to contact the insurance company?

Yes, you will need what is known as prior authorization

What is the emergency room copay?

It has a $0 copay

A specialist wants me to have blood work done, will it be covered

No. your primary doctor needs to order bloodwork

Is dialysis a covered benefit?

Yes, both Hemodialysis and Renal Dialysis are covered.

My child is a diabetic. Will the insulin pump be covered?

Yes, though contact the health insurance provider for complete details

Is anesthesia covered or will I have to pay?

If medically necessary then its fully covered

Can my family be covered?

No, only children under 19 years of age