Medicaid Letters: Child Health Plus

What is the Child Health Plus Program?

Child Health Plus is an affordable health insurance plan offered through New York State for children and teens up to age 19 who have no health insurance coverage or have a plan that offers less coverage than CHP. It provides a way for children and teens to get the medical exams and follow-up care they need on a scheduled basis. Even if you are working, your children may be eligible.

What will CHP include?

    – office visits                                                       – prescription drugs
    – hearing, lab and eye tests                              – non-prescription drugs
    – emergency services                                        – X-rays
    – any needed shots                                            – hospital care
    – referral for dental care                                 – surgical care
    – testing for lead poisoning                             – durable medical equipment
    – specialists                                                         – therapeutic services
    – home health care                                            – mental health services
    – chemotherapy                                                  – routine dental care                       – eyeglasses                                                          – substance abuse services

Who is eligible for CHP?

Children and teens in Erie County up to age 19 who have no health insurance coverage or have a plan that offers less coverage than CHP are eligible for CHP. You can enroll your child in Child Health Plus even if your family income is much higher than Medicaid allows.

Is my child eligible if he or she has a medical problem at the time of application?

Yes. Even if your child already has a medical problem, he or she may still be eligible.

What does it cost?

There are no co-payments for any doctor’s visits or prescriptions. Depending on your gross family income, you may have to pay a fee every year for each child to enroll. See the charts below.

CHILD HEALTH PLUS A INCOME GUIDELINES

Age Categories for Children

1

2 3 4 5 Each Additional Person Add:

Children Under 1 Year; Pregnant Women*

1,587 2,130 2,674 3,217 3,760 544

Children 1-18 Years

1,056 1,417 1,778 2,140 2,501 362

* Pregnant Women count as two

CHILD HEALTH PLUS B INCOME GUIDELINES

Household Size If your gross
family
income is below
this amount
the program is

FREE

If your gross family
income is between
these amounts,
the program cost is

$9.00 per child
per month

If your gross family
income is between
these amounts,
the program cost is

$15.00 per child
per month

If your gross family
income is above
these amounts,
the program cost is

* FULL PREMIUM

GROSS FAMILY MONTHLY INCOME

1 Below- 1,269 1,762 1,984 Above – 1,984
2 1,703 2,365 2,663 2,663
3 2,138 2,968 3,342 3.342
4 2,573 3,571 4,021 4,021
5 3,007 4,174 4,700 4,700
Each Additional Person Add: 435 604 680  
Effective 01/01/05
* The full premium will vary depending on the insurer selected. It is probably much less than you would pay for other private insurance.

Where can my children go for health care when they are enrolled in CHP?

Once you enroll, you will be given a list of providers near you. The provider may be a single doctor, group practice of several doctors, or community health center. You may then choose who you want to provide medical services from this list.

Where do I call for more information about CHP?

You may call one of the following:

Department of Health Growing Up Healthy Hotline 1-800-698- KIDS (4543)
Buffalo Community Health 1-800-683-3781
Blue Cross/Blue Shield of W.N.Y. 1-800-888-5407
Fidelis Care NY 1-888-343-3547

I am a teenager, can I apply for CHP myself?

Yes. If you are under 18 years of age and can show that you have a place of residence, you may apply for yourself, even if you live with a family member. If you do live with a family member-and you do not pay rent, their income will be considered in determining your eligibility. You will not be required to get a family member’s approval or signature when you apply.

BATAVIA OFFICE

45 Main Street
Batavia, NY 14020


(Tel) 585.343.5450

(Fax) 585.343.5503


Serving Orleans, Genesee
and Wyoming Counties

BUFFALO OFFICE

Administrative Offices
237 Main Street, Ste. 400
Buffalo, NY 14203

(Tel) 716.847.0650
(Fax) 716.847.0227
(TDD) 716.847.1322

Serving Erie County

NIAGARA FALLS OFFICE

225 Old Falls Street
3rd Floor
Niagara Falls, NY 14302

(Tel) 716.284.8831
(Fax) 716.284.8040


Serving Niagara County

NLS will not provide legal advice over the internet. The information on this website is not legal advice. Legal advice is dependent upon the specific circumstances of each situation. Also, the law may vary from State to State, so that some information in this website may not be correct for your jurisdiction. Finally, the information contained in this website is not guaranteed to be up to date. Therefore, the information contained in this website cannot replace the advice of competent legal counsel licensed in your state.

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