How Do I Apply?
Call this toll-free number: 1-800-698-4KIDS (1-800-698-4543), and ask about Child Health Plus. (If you are hearing impaired, call the TTY number, 1-877-898-5849.) If you are eligible for Children's Medicaid (see "Who is eligible?"), ask for organizations in your community who can help you enroll. Or you can enroll through your local Department of Social Services. The address and phone number for your local Department of Social Services is here. If your income is above Children's Medicaid levels, you can enroll with a Child Health Plus insurer directly. Participating Child Health Plus insurers are listed by county here on this web site. Each insurer offers health care through many providers. The insurer will send you an application and give you a list of providers in your area.
If you would like someone to assist you in applying for either Children's Medicaid or Child Health Plus, there are enrollers in your community who can help. These enrollers will help you fill out the application, collect the necessary documents, and select a health plan. In many cases, assistance is available during evenings and weekends. To learn the nearest location where application assistance is available, please call 1-800-698-4KIDS (1-800-698-4543), or check the list on this web site.
Application Forms
The ACCESS NY Health Care application can be used to apply for Medicaid, Child Health Plus, and Family Health Plus programs. Based upon the information you provide, you will be told which program you and/or your child(ren) are eligible for. You can use the ACCESS NY Public Health Insurance Eligibility Screening tool to see which public health insurance programs you and your family may be eligible for.
Now that you have used the screening tool, there are a few ways you can fill out the ACCESS NY Health Care application. You can use the "Fill and Print" ACCESS NY Health Care application. With the "Fill and Print" ACCESS NY Health Care application, you can fill out the application on your screen and print the completed form. Please note that if you choose to use the "Fill and Print" ACCESS NY Health Care application, you will not be able to save the information you typed into the application to your computer.
You can also print a blank ACCESS NY Health Care application and fill it out by hand. The entire Access NY Health Care application is available as an Adobe Acrobat Portable Document Format file. Please use the help available in your county to assist you with completing the application.
You can then mail or drop off your application and the required documents to your local department of social services. If you are only applying for only Child Health Plus, you can mail in or drop off your application and required documents to a Child Health Plus Health Plan.
You can get a hardcopy of this application by calling 1-800-698-4543 or by emailing chplus@health.state.ny.us. If you are hearing impaired, call the TTY number, 1-877-898-5849.
English
- Instructions (PDF, 281KB, 4pg.)
- Application (PDF, 415KB, 9pg.)
- Documents Needed When You Apply for Health Insurance (PDF, 259KB, 3pg.)
- Fact Sheet (PDF, 111KB, 1pg.)
- Supplement A (PDF, 147KB, 2pg.)
- Instructions and Application in One File (PDF, 610KB, 16pg.)
Spanish
- Instrucciones (PDF, 2.07MB, 4pg.)
- Applicación (PDF, 225KB, 6pg.
- Documentos Necesarios Para Solicitar Seguro médico (PDF, 154KB, 4pg.)
- Hoja de Hechos (PDF, 61KB, 1pg.)
- Suplemento A (PDF, 147KB, 6pg.)



