Child Health Plus Fact Sheet

An estimated 434,000 children and teens statewide, including 211,000 in New York City, lack health insurance.

Effective Sept. 1, as a result of legislation approved by Governor David A. Paterson and the State Legislature, children in families with annual incomes up to $70,000 for a family of three ($84,000 for family of four) are eligible to obtain subsidized coverage under New York's Child Health Plus insurance program.

On Saturday from 10 a.m. to 3 p.m. enrollers will be on site at the Bronx Zoo to provide information about Child Health Plus and assist with applications. As a result of a partnership with the Wildlife Conservation Society, which manages the zoo, families participating in this event will receive free admission to the zoo.

The estimated breakdown of total uninsured children and teens by borough in New York City is:

  • Bronx – 49,100
  • Brooklyn – 78,600
  • Manhattan – 20,200
  • Queens – 56,300
  • Staten Island – 6,400

Child Health Plus provides free or reduced cost health insurance for uninsured children up to age 19. Families should NOT drop existing coverage for their children in order to enroll in Child Health Plus. Families who drop employer-sponsored coverage in order to sign up for Child Health Plus will be subject to a six-month waiting period. There are some exceptions to the waiting period, including:

  • Involuntary loss of a job resulting in the loss of health insurance
  • Death of family member providing coverage resulting in loss of coverage
  • Person providing coverage had a change of job and new employer does not provide coverage
  • Employee moved and no employer-based health coverage is available
  • Employer stopped offering coverage to all employees
  • Health benefits were terminated due to long-term disability
  • Coverage through COBRA has expired
  • Pregnant child/teen is applying

With coverage through Child Health Plus and Medicaid, children can get the care they need when they need it, including:

  • Regular check-ups
  • Vaccinations
  • Prescriptions
  • Doctor visits when they are sick
  • Dental and vision care
  • Hospital and emergency care
  • And much more……

How much a family pays for insurance through Child Health Plus depends on their income and the number of people in their household. The health insurance is free for children in families with lowest incomes. Other families pay a monthly premium ranging from $9 - $40 per child per month, depending on income. Families whose incomes exceed 400 percent of the federal poverty level ($70,000 for a family of 3; $84,000 for a family of 4) can still buy in to Child Health Plus by paying the full monthly premium of about $156, which is still more affordable than insurance currently available on the private market.

Approximately 64,000 children and teens statewide are eligible for subsidized coverage as a result of the expanded eligibility for Child Health Plus. However, the New York State Health Department is trying to enroll thousands more uninsured children who are eligible for either Medicaid or the original Child Health Plus program and are not currently enrolled. An estimated 90 percent of the 434,000 uninsured children in New York State are currently eligible for subsidized coverage in Medicaid and Child Health Plus. The remaining 10 percent of uninsured children in families with incomes above 400 percent of the federal poverty level can also enroll their children in Child Health Plus by paying the full monthly premium.

To get coverage for their children, parents can apply right in their own neighborhood with help from enrollment counselors called Facilitated Enrollers. To find a facilitated enroller closest to them, families can call 1-800-698-4KIDS or 1-800-698-4543.

For more information about Child Health Plus call 1-800-698-4KIDS or 1-800-698-4543 or visit the Child Health Plus website at http://www.health.ny.gov/health_care/child_health_plus/