Child Health Plus (CHP) offers comprehensive health insurance for uninsured children up to age 19. CHP is for children who are not eligible for Medicaid due to their income or immigration status. CHP enrollees must enroll in a managed care plan to receive services. See the questions below to determine if your child qualifies for CHP and if it is the best option for you.
Who is eligible for Child Health Plus?
Children may qualify for CHP if:
- They are under age 19
- They are New York State residents
- They are not eligible for Medicaid or covered by other health insurance
- They are not eligible for or enrolled in a health plan through a state health benefits program (NYSHIP)
*All children are eligible regardless of immigration status
How much does Child Health Plus cost?
The table below shows costs. Monthly premiums depend on income and family size (based on 2020 Income Limits). There is no cost for low income families. Families with higher incomes pay a sliding scale premium as low as $9 and as high as $60 per child, per month. The chart below shows how much per month a family will pay based on their income. The premium is capped at the monthly cost for three children. For example, if a family with four children qualifies for CHP at $9 per month, per child, their monthly premium will only be $27 to cover all four children.
There are no annual deductibles and no co-pays for services in Child Health Plus plans.
|Family Contributions||Monthly income by family size (based on 2020 income limits)||Each add’l person, add:|
|$9 per child per month (Maximum of $27 per family)||$2,361||$3,190||$4,019||$4,847||$5,676||$6,505||$7,334||$8,163||$829|
|$15 per child per month (Max. of $45 per family)||$2,659||$3,592||$4,525||$5,459||$6,392||$7,325||$8,259||$9,192||$934|
|$30 per child per month (Max. of $90 per family)||$3,190||$4,310||$5,430||$6,550||$7,670||$8,790||$9,910||$11,030||$1,120|
|$45 per child per month (Max. of $135 per family)||$3,722||$5,029||$6,335||$7,642||$8,949||$10,255||$11,562||$12,869||$1,307|
|$60 per child per month (Max. of $180 per family)||$4,254||$5,747||$7,240||$8,734||$10,227||$11,720||$13,214||$14,707||$1,494|
|Full premium per child per month||Over $4,254||Over $5,747||Over $7,240||Over $8,734||Over $10,227||Over $11,720||Over $13.214||Over $14.707||Over $1,494|
What services does Child Health Plus cover?
CHP will cover essential health benefits (EHBs), including:
- Well-child care
- Physical exams
- Diagnosis and treatment of illness and injury
- X-ray and lab tests
- Outpatient surgery
- Emergency care
- Prescription and non-prescription drugs
- Inpatient hospital medical or surgical care
- Short-term therapeutic outpatient services (chemotherapy, hemodialysis)
- Inpatient and outpatient treatment for alcoholism and substance abuse, and mental health
- Dental/Vision care
- Speech and hearing
- Durable medical equipment
- Emergency ambulance transportation to a hospital
How do I enroll my child in Child Health Plus?
You can enroll in person, online, or over the phone. If you need assistance enrolling into CHP or want more information, please contact CHA at 888-614-5400.