Child Health Plus is New York’s health plan for children under 19 who don’t qualify for Children’s Medicaid, and you can enroll at any time of year. It is run by the New York State Department of Health, and you apply through NY State of Health, the state’s official health plan marketplace. The rules are the same in New York City, Long Island, Buffalo, Rochester, Syracuse, Albany, the Hudson Valley, or anywhere else in the state.
This article is educational. Instant Health Help is a licensed health insurance agency, and our agent, Lobsang Rivas, is licensed in New York and certified as a broker with NY State of Health. We are not NY State of Health, the Department of Health, or an insurance company, and the state decides who qualifies. We do not quote prices or name plans here. See the official rules on the Child Health Plus eligibility and cost page.
The short answer
- Child Health Plus is for New York children under 19 who don’t qualify for Children’s Medicaid and don’t already have health insurance.
- The monthly premium depends on income and family size. Families with lower incomes pay no monthly premium, and there are no copays and no annual deductible.
- You can enroll any time, not just during open enrollment, through NY State of Health.
Who qualifies for Child Health Plus
The Department of Health lists these rules:
- The child is under age 19 and lives in New York State.
- Whether a child gets Children’s Medicaid or Child Health Plus depends on gross family income. Children with lower incomes usually go to Medicaid.
- A child who isn’t eligible for Medicaid can enroll in Child Health Plus if the child doesn’t already have health insurance and isn’t eligible for coverage through the public employees’ state health benefits plan.
You don’t have to decide between Medicaid and Child Health Plus yourself. One NY State of Health application checks both.
How the premium works
The Department of Health explains it in three tiers, based on how your family income compares with the federal poverty level:
- Less than 2.2 times the poverty level: no monthly premium.
- Somewhat higher incomes: a set monthly premium for each child, based on income and family size. For larger families, the monthly fee is capped at three children.
- More than 4 times the poverty level: the family pays the full monthly premium charged by the health plan.
We don’t list dollar amounts here because they change. Check the current table on the Department of Health page. Either way, the state says there are no copays for services under Child Health Plus, and NY State of Health says there is no annual deductible.
How to enroll
NY State of Health says you can enroll your child in Child Health Plus at any time during the year. You can apply online, by phone, or with in-person help:
- Online through NY State of Health. See its Child Health Plus page.
- By phone: the NY State of Health Customer Service Center is 1-855-355-5777. The Department of Health also has a Child Health Plus line at 1-800-698-4543, TTY 1-877-898-5849.
- With a broker or assistor who is certified with NY State of Health.
Have each child’s birth date, Social Security number if they have one, and your household’s income information ready. If your child already has Child Health Plus, watch for renewal notices. NY State of Health says you may need to take action to keep the coverage.
A note on the recent federal changes
New federal rules changed which immigrants qualify for some federally funded coverage in New York. NY State of Health says health coverage for children, pregnant individuals, and those who recently gave birth has not changed, and many children and pregnant individuals will keep the same coverage options. If your family has questions about a specific situation, ask NY State of Health or talk with us before you assume a child doesn’t qualify.
What about the parents?
Adults in the same household may qualify for Medicaid, the Essential Plan, or a Qualified Health Plan through NY State of Health, depending on income and other rules. Our Essential Plan guide explains the Essential Plan, and our New York open enrollment guide covers the dates and steps for adults.
You may qualify after tax credits. Eligibility varies.
If you live across the line in Connecticut, Pennsylvania, Vermont, or Massachusetts, apply in your own state. Our agent is not licensed in those states. We are licensed in New Jersey too.
How we help
Our agent is certified as a broker with NY State of Health, so we can go through the application with you, compare plans, and help you enroll, at no extra cost to you for our help. We are not NY State of Health, and NY State of Health decides what you qualify for. Learn more on our New York health insurance help page. We help by phone and online, in English or Spanish, and we look at the whole household, so the kids and the adults each land in the right program.
Want to talk it through?
Have your household’s income information and a list of who needs coverage ready, and we can go over it with you.
Call (321) 315-0054 | agent@inshh.com
Featured photo: Keuka Lake, Finger Lakes, New York by Shuvaev, CC BY-SA 4.0, cropped with text added.