With MetroPlus Child Health Plus, you receive free or low cost New York State-sponsored health insurance for your children. MetroPlus Child Health Plus is available to qualified children under the age of 19 who live in Brooklyn, Manhattan, Queens or the Bronx and are not eligible for Medicaid, do not already have health insurance and are not eligible for coverage under the public employees' state health benefits plan.
Some children who were covered by employer-based health insurance within the past six months may be subject to a waiting period before they can be enrolled in Child Health Plus. Determining whether your child is subject to a waiting period will depend on your household income and the reason your child lost employer-based coverage. Check the charts below to see whether your child may qualify for Children's Medicaid or Child Health Plus.
Child Health Plus Family Contributions by Income and Household Size*
Premium Categories
Monthly Income by Family Size**
Each Add'l.
Person, Add:
1
2
3
4
5
6
Free Insurance
$1,451
$1,961
$2,470
$2,979
$3,489
$3,998
$510
$9/child per month
(Maximum of $27 per family)
$2,015
$2,722
$3,429
$4,135
$4,842
$5,549
$707
$15/child per month
(Maximum of $45 per family)
$2,269
$3,065
$3,861
$4,657
$5,453
$6,248
$796
$30/child per month
(Maximum of $90 per family)
$2,723
$3,678
$4,633
$5,588
$6,543
$7,498
$955
$45/child per month
(Maximum of $135 per family)
$3,177
$4,291
$5,405
$6,519
$7,633
$8,748
$1,115
$60/child per month
(Maximum of $180 per family)
$3,630
$4,904
$6,177
$7,450
$8,724
$9,997
$1,274
Full Premium**
per Child per Month
Over
$3,630
Over
$4,904
Over
$6,177
Over
$7,450
Over
$8,724
Over
$9,997
* Effective 4/1/2011; income levels are subject to change.
**The full premium varies, depending on the health plan chosen by the family.
Medicaid Income Eligibility Levels*
Age Categories for Children
Monthly Income by Family Size
Each Additional
Person, Add:
1
2
3
4
5
6
Children under 1 year; Pregnant Women (count as two people)
$1,815
$2,452
$3,089
$3,725
$4,362
$4,999
$637
Children 1-5 year
$1,207
$1,631
$2,054
$2,478
$2,901
$3,324
$424
Children 6-18 year
$908
$1,226
$1,545
$1,863
$2,181
$2,500
$319
Children 19-20 yrs; Parents
$767
$1,117
$1,285
$1,452
$1,620
$1,787
$168
Non-Disabled Single Adults and Childless Couples, 21-64 yrs.
$708
$883
* Effective 4/1/2011; income levels are subject to change.
MetroPlus Child Health Plus offers benefits such as:
• Regular check-ups and office visits with your own Primary Care Provider (PCP)
• Well-baby and well-child care visits
• Immunizations
• Referrals to specialists in our network with no referral forms
• Live customer service representatives who speak your language
• 24-hour emergency hotline
• Lab tests and x-rays
• Emergency and hospital care
• Dental care
• Vision care
• Prescriptions
When you enroll in MetroPlus Child Health Plus, you have a choice of at least three PCPs. If you want to continue to see your current doctor, make sure that your doctor is in the MetroPlus network.
For more information, call MetroPlus Customer Services, Monday - Saturday, 8 am - 8 pm, 800-475-METRO (800-475-6387), TTY 800-881-2812
