In New York, the Children’s Health Insurance Program (CHIP) is known as Child Health Plus. It provides low-cost or free health insurance for children in families with incomes too high for Medicaid but who still need affordable coverage .
This guide covers eligibility, costs, and step-by-step application instructions.
What Is Child Health Plus?
Child Health Plus is New York’s separate CHIP program offering comprehensive health coverage for children up to age 19 . Covered services include:
- Routine check-ups and immunizations
- Doctor visits and prescription drugs
- Emergency services and hospitalization
- Dental and vision care
The program is administered through NY State of Health, New York’s official health plan marketplace .
Eligibility Requirements
Income Limits
New York has the highest CHIP income threshold in the country, with eligibility up to 405% of the Federal Poverty Level (FPL) .
| Household Size | Maximum Monthly Income (405% FPL) |
|---|---|
| 1 person | $5,386 |
| 2 people | $7,302 |
| 3 people | $9,221 |
| 4 people | $11,137 |
| Each additional person | +$1,915 |
Eligibility varies slightly by age and income level :
| Age Group | Medicaid (free) | Child Health Plus (low-cost) |
|---|---|---|
| Ages 0-1 | Up to 223% FPL | 219-400% FPL |
| Ages 1-5 | Up to 154% FPL | 150-400% FPL |
| Ages 6-18 | Up to 154% FPL | 150-400% FPL |
Additional Requirements
- Age: Under 19 years old
- Residency: Must live in New York State
- Insurance status: Child must be uninsured (no waiting period requirement in New York)
- Immigration status: Lawfully residing children are eligible without a five-year waiting period
Costs and Premiums
Child Health Plus offers sliding scale premiums based on family income :
| Family Income (% FPL) | Monthly Premium per Child |
|---|---|
| 160-222% FPL | 9−9−27 max |
| 223-250% FPL | 15−15−45 max |
| 251-300% FPL | 30−30−90 max |
| 301-350% FPL | 45−45−135 max |
| 351-400% FPL | 60−60−180 max |
| Above 400% FPL | Full premium (buy-in option available) |
There are no copays for office visits, inpatient services, or prescription drugs regardless of income level .
How to Apply for Child Health Plus
Online (Recommended)
Apply through the NY State of Health website:
- Visit nystateofhealth.ny.gov
- Create or log in with your ny.gov ID (same as unemployment benefits account)
- Complete a single application—it will automatically check eligibility for Medicaid, Child Health Plus, and the Essential Plan
By Phone
Call the NY State of Health Customer Service Center:
With In-Person Assistance
Free, trained enrollment assistors are available throughout New York State. To find an assistor near you, call 1-855-355-5777 .
For NYC residents: Contact MetroPlus at 855-809-4073 (Monday-Friday, 9 AM – 5 PM)
For non-NYC residents: Contact Empire BlueCross BlueShield at 888-809-8009, press option 4 (Monday-Friday, 9 AM – 5 PM; Saturday, 9 AM – 1 PM)
Documents You May Need
While not required to start the application, having this information ready will speed up the process:
- Proof of child’s age (birth certificate, passport)
- Proof of residency (utility bill, lease)
- Income documentation (pay stubs, tax returns, employer letter)
- Immigration documents (if applicable)
- Social Security numbers (optional but helpful)
What Happens After You Apply?
- Determination: NY State of Health processes applications and determines eligibility (typically within 30 days)
- Plan selection: Families can choose from participating health plans (different insurers offer Child Health Plus)
- Coverage start: Usually begins the first day of the month following application approval
- 12-month continuous eligibility: Once enrolled, children remain covered for 12 months even if family income changes
Key Takeaways
| Feature | Details |
|---|---|
| Program name | Child Health Plus |
| Income limit | Up to 405% FPL (highest in US) |
| Age limit | Under 19 years old |
| Waiting period | None |
| Premium range | 0−0−180/month (sliding scale) |
| Copays | None |
| Immigrant eligibility | Lawfully residing children eligible |
| Application method | Online, phone, or in-person assistance |
| Application website | nystateofhealth.ny.gov |
| Application phone | 1-855-355-5777 |
Frequently Asked Questions
Q: Can my child get Child Health Plus if we already have private insurance?
A: No. Child Health Plus is only for uninsured children .
Q: Is there a waiting period if my child recently lost other coverage?
A: No. New York does not require a waiting period .
Q: What if our income is above 400% FPL?
A: Families above 400% FPL can still enroll by paying the full premium through the “buy-in” option .
Q: Does Child Health Plus cover dental and vision?
A: Yes, comprehensive dental and vision services are included .
Q: Can undocumented immigrants apply for their children?
A: Lawfully residing children are eligible. New York also offers state-funded coverage options for some children regardless of immigration status .
For the most current information or to start an application, visit nystateofhealth.ny.gov or call 1-855-355-5777. Assistance is available in multiple languages at no cos
