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Frequently Asked Questions

Here are answers to some of the most commonly asked questions about MVP’s free and low cost health insurance options.

Child Health Plus

  • Who can enroll in Child Health Plus?

    Child Health Plus is a health insurance program for children in families who are:

    • Under the age of 19 years old
    • Not covered by private health insurance, such as employer-based health insurance*
    • Not eligible for Medicaid
    • Qualified for CHPlus based on income level
    • New York residents, whether or not they are documented U.S. residents

    If you live in Albany, Columbia, Dutchess, Genesee, Greene, Jefferson, Lewis, Livingston, Monroe, Oneida, Ontario, Orange, Putnam, Rensselaer, Saratoga, Schenectady, Sullivan, Rockland, Ulster, Warren, Washington or Westchester counties:

    Medicaid Coverage MapCall MVP Health Care to Learn More

    • 1-800-825-5687 
    • Monday – Friday from 8:30 am to 5 pm Eastern Time

    If you live in a county that is not listed above, please contact the New York State Department of Health to learn more about the Child Health Plus options in your area.

    *Some children who had employer-based health insurance may be subject to a waiting period of no more than 90 days before they can be enrolled in CHPlus. This will depend on your household income and the reason your children lost employer-based coverage.


  • What are the income limits for Child Health Plus?

    The income limits vary depending upon the family size. Reference the below to see if you may be eligible for Child Health Plus:

     


  • What benefits are covered by Child Health Plus?

    Child Health Plus Subscriber Contract

    Your child will have access to a range of health care services under Child Health Plus. Some families pay a monthly premium for coverage. However, there are no co-pays for services. That means you don’t have to pay anything for the care your child receives through the plan.

    With MVP, you have a range of options for primary and specialty care from participating doctors and health centers. We have many doctors, health centers and hospitals in our service area that are ready to help you. We also offer dental care, eye care and other services designed to help your child’s health.

    Child Health Plus benefits include:

    • No limit on needed visits to your doctor (Primary Care Physician)—Covered in full
    • Maternity and baby care—Covered in full
    • Non-urgent emergency room—Covered in full
    • Eye exams and eyeglasses—Covered in full with some limits
    • Many specialists to choose from—Covered in full
    • Lab tests—Covered in full
    • X-rays—Covered in full
    • Hearing services—Covered in full
    • Physical, occupational and speech therapy—Covered in full (short term therapy)
    • Mental health/alcohol and substance use disorder treatment—Covered in full
    • Condition Health and Case Management Programs to help you live well with ongoing illnesses like diabetes and asthma—Free
    • Little FootprintsSM prenatal program to take care of new moms—Free
    • Family planning and reproductive health services—Covered in full
    • HIV testing and counseling—as part of a family planning visit—Covered in full
    • Over the Counter (OTC) drugs—Covered in full
    • Medical Supplies—Limited coverage
    • Dental service—Covered
    • Prescription Drugs:
    • Can be filled at any participating Medicaid pharmacy, if your doctor orders them—Covered in full
    • Brand Name Drugs—No co-payment
    • Preferred Brand Name Drugs*—No co-payment
    • Generic Drugs—No co-payment
    • OTCs—No co-payment
    • Medical Supplies—No co-payment
    • Hearing Aid Batteries—No co-payment
    • Enteral Formula—No co-payment
    • Diabetic Supplies—No co-payment

    Note: This summary of benefits is only an overview of plan provisions. While every effort has been made to ensure that this summary accurately reflects the provisions of each plan, it is the plan contract that governs the operations of individual plans and payment of all benefits.


  • How do I apply for Child Health Plus?

    Families can enroll in Child Health Plus at any time during the year. Get ready to enroll by gathering documents regarding your household income and the age(s) of your children:

    Proof of current income. For example:

    • Paycheck stubs or records of earnings
    • Veterans’ benefits, unemployment benefits, Social Security, Workers’ Compensation, child support/alimony

    Proof of child’s age, address and identity. Any of the following:

    • Birth certificate
    • Driver’s license or state ID card with photo
    • ID card issued by a federal, state or local government
    • School ID card with a photo (may also show date of birth)
    • Certificate of Degree of Indian blood or other Native American/Alaska Native tribal document with photo
    • Verified school, nursery or daycare records (for children under 16, may also show date of birth)
    • Clinic, doctor or hospital records (for children under 16)

    We’re here to help you find the right plan for you and your family. If you think you qualify, even if you’re not sure, get started with the enrollment process online now.

    Get started now online

    If you live in Albany, Columbia, Dutchess, Genesee, Greene, Jefferson, Lewis, Livingston, Monroe, Oneida, Ontario, Orange, Putnam*, Rensselaer, Saratoga, Schenectady, Sullivan, Rockland, Ulster, Warren, Washington or Westchester counties:

    Medicaid Coverage MapCall MVP Health Care to Learn More

    • 1-800-825-5687 
    • Monday – Friday from 8:30 am to 5 pm Eastern Time

    If you live in a county that is not listed above, please contact the New York State Department of Health to learn more about the Child Health Plus options in your area.

    *Essential Plan not available in Putnam county.


Have questions about Medicaid and Essential plans? Learn More