Jeffrey Wade
New York State offers a health insurance plan for children called Child Health Plus. This plan provides no- or low-cost healthcare coverage for children under 19 who aren't eligible for Medicaid. Children can qualify for Child Health Plus regardless of family income or immigration status. The monthly premium price depends on household income and family size, with no monthly premium for families with lower incomes. Child Health Plus covers hospital, emergency room, retail health clinic, and urgent care visits, as well as dental care and exams, including braces if they are medically necessary.
| Characteristics | Values |
|---|---|
| Name of the plan | Child Health Plus |
| Administered by | New York State Department of Health |
| Availability | Available for children under 19 |
| Eligibility | Children who are not eligible for Children's Medicaid |
| Enrollment | Can be done at any time during the year through NY State of Health |
| Premium | Depends on household income and family size. No monthly premium for families with lower incomes. |
| Annual deductible | None |
| Co-payments | None |
| Coverage | Hospital, emergency room, retail health clinic, and urgent care visits. Dental and vision benefits are also included. |
| Rating | Measured on a five-star scale by the NYSDOH |
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What You'll Learn
- Child Health Plus: New York State's health insurance plan for children under 19
- Eligibility: Children can qualify regardless of family income or immigration status
- Cost: Monthly premium depends on household income and family size
- Medicaid: Children who aren't eligible for Medicaid can enroll in Child Health Plus
- Changes: New federal rules could impact health insurance plans
Child Health Plus: New York State's health insurance plan for children under 19
Child Health Plus is a New York State-sponsored health insurance plan that provides no- or low-cost healthcare coverage for children under 19 who aren't eligible for Medicaid. Children can qualify for the plan regardless of family income or immigration status. To be eligible, children must be under the age of 19 and be residents of New York State.
Whether a child qualifies for Children's Medicaid or Child Health Plus depends on gross family income. Children who are not eligible for Medicaid can enrol in Child Health Plus if they don't already have health insurance and are not eligible for coverage under the public employees' state health benefits plan. There is no monthly premium for families whose income is less than 2.2 times the poverty level. That's about $1,232 a week for a three-person family and about $1,487 a week for a family of four. Families with somewhat higher incomes pay a monthly premium of $15, $30, $45, or $60 per child per month, depending on their income and family size. For larger families, the monthly fee is capped at three children. If the family's income is more than four times the poverty level, they pay the full monthly premium charged by the health plan.
Child Health Plus covers hospital, emergency room, retail health clinic, and urgent care visits. It also covers dental care and exams, including braces if they are medically necessary. There are no co-payments for services under Child Health Plus, so you don't have to pay anything when your child receives care through these plans.
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Eligibility: Children can qualify regardless of family income or immigration status
In New York State, children under the age of 19 can qualify for no- or low-cost healthcare coverage under the Child Health Plus plan, regardless of family income or immigration status. This plan is sponsored by the state and covers children who aren't eligible for Medicaid.
Whether a child qualifies for Children's Medicaid or Child Health Plus depends on gross family income. Children who are not eligible for Medicaid can enroll in Child Health Plus if they don't already have health insurance and are not eligible for coverage under the public employees' state health benefits plan. There is no monthly premium for families whose income is less than 2.2 times the poverty level. That's about $1,232 a week for a three-person family and about $1,487 a week for a family of four. Families with somewhat higher incomes pay a monthly premium of $15, $30, $45, or $60 per child per month, depending on their income and family size. For larger families, the monthly fee is capped at three children. If the family's income is more than four times the poverty level, they pay the full monthly premium charged by the health plan.
Child Health Plus covers hospital, emergency room, retail health clinic, and urgent care visits, as well as dental care and exams, including braces if they are medically necessary. There are no co-payments for services under Child Health Plus, so you don't have to pay anything when your child receives care through these plans.
To apply for Child Health Plus, you can use the NY State of Health website or call their customer service center at 1-855-355-5777.
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Cost: Monthly premium depends on household income and family size
In New York State, Child Health Plus provides no- or low-cost healthcare coverage for children under 19 who aren't eligible for Medicaid. Children can qualify for the plan, sponsored by the state, regardless of family income or immigration status.
The monthly premium price depends on household income and family size. There is no monthly premium for families with lower incomes. For example, there is no monthly premium for families whose income is less than 2.2 times the poverty level. That's about $1,232 a week for a three-person family, or about $1,487 a week for a family of four.
For families with somewhat higher incomes, the monthly premium is $15, $30, $45, or $60 per child per month, depending on income and family size. For larger families, the monthly fee is capped at three children. If the family's income is more than four times the poverty level, they pay the full monthly premium charged by the health plan.
There are no co-payments for services under Child Health Plus, so you don't have to pay anything when your child receives care through these plans.
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Medicaid: Children who aren't eligible for Medicaid can enroll in Child Health Plus
Children who are residents of New York State and are under the age of 19 can apply for Children's Medicaid or Child Health Plus. Whether a child qualifies for either of these programs depends on gross family income. Children who do not qualify for Medicaid can enrol in Child Health Plus if they do not have existing health insurance and are not eligible for coverage under the public employees' state health benefits plan.
Child Health Plus is a New York State-sponsored program that provides no- or low-cost healthcare coverage for children under 19. It is available at a reduced premium to children in families who are up to 400% of the Federal Poverty Level ($58,280 for a family of two) and at a full price for children above that level. There is no monthly premium for families whose income is less than 2.2 times the poverty level. That's about $1,232 a week for a three-person family and about $1,487 a week for a family of four. Families with somewhat higher incomes pay a monthly premium of $15, $30, $45, or $60 per child per month, depending on their income and family size. For larger families, the monthly fee is capped at three children.
Child Health Plus covers hospital, emergency room, retail health clinic, and urgent care visits. It also covers dental care and exams, including braces if they are medically necessary. There are no co-payments for services under Child Health Plus, so there are no out-of-pocket costs when your child receives care through these plans.
To apply for Child Health Plus, you can use the NY State of Health website or call their customer service centre at 1-855-355-5777. You can also use the Plans by County Tool to learn what health plans are available in your county and the NYS Provider & Health Plan Look-Up tool to decide which health plan to enrol in or to find a provider that works with your plan.
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Changes: New federal rules could impact health insurance plans
In New York State, children under the age of 19 who are residents of the state can enrol in Children's Medicaid or Child Health Plus. Child Health Plus is a state-sponsored plan that provides no- or low-cost healthcare coverage for children who aren't eligible for Medicaid. Whether a child qualifies for either of these plans depends on their family's gross income.
The Centers for Medicare & Medicaid Services (CMS) has finalized a major rule that will lower individual health insurance premiums by approximately 5% on average. The rule combats the surge of improper enrolments in the Affordable Care Act (ACA) Exchanges and reins in wasteful federal spending. The rule is projected to save taxpayers up to $12 billion in 2026.
CMS has also taken steps to stabilize the risk pool, lower premiums, and reduce improper enrolments, with the goal of improving healthcare affordability and access while maintaining fiscal responsibility. This includes repealing the monthly special enrollment period (SEP) for individuals with projected household incomes at or below 150% of the federal poverty level, a policy that was previously used to improperly enrol ineligible consumers.
Additionally, CMS is reinstating its longstanding 2012 interpretation of "lawfully present" to exclude Deferred Action for Childhood Arrivals (DACA) recipients from eligibility and enrollment in ACA Exchange coverage and Basic Health Program (BHP) coverage in specific states.
CMS is also standardizing the Annual Open Enrollment Period starting with the 2027 plan year, so it ends by December 31 for all health insurance exchanges. This change encourages individuals to maintain year-round health coverage and helps keep insurance affordable.
Furthermore, a finalized federal rule announced by the Departments of Treasury, Health and Human Services, and Labor in March 2024 has imposed new nationwide duration limits on short-term limited-duration insurance (STLDI) plans. The rule limits new STLDI plans to three-month terms and caps the total duration, including renewals, at four months. This rule is intended to make it easier for consumers to distinguish between comprehensive ACA-compliant insurance and STLDI.
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Frequently asked questions
Child Health Plus is a health insurance plan for children in New York State.
You can apply for Child Health Plus at any time during the year through the NY State of Health website.
The monthly premium price depends on household income and family size. There is no monthly premium for families with lower incomes. Families with higher incomes may pay a monthly premium of $15, $30, $45, or $60 per child per month.
