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UnitedHealthcare Community Plan
UnitedHealthcare Community Plan

Child Health Plus

Frequently Asked Questions

Q.
What is Child Health Plus?
A.

Child Health Plus is a New York State health insurance plan for kids. Your child may be eligible for Child Health Plus or Children’s Medicaid depending upon your family income and household size.

Q.
How do I apply for Child Health Plus
A.

You can apply for Child Health Plus by the visiting the New York State of Health website, or by calling 1-855-355-5777. UnitedHealthcare wants to help you and has Certified Application Counselors who will assist you with applying. Just call 1-888-617-8979 to have a Certified Application Counselor help you.

Q.
I’m required to pay a premium for my child, how do I do that?
A.

When you enroll in CHPlus and select UnitedHealthcare you must be pay your premium prior to the month that coverage will begin. If your coverage is effective January 1, your payment must be received before that date. We'll provide a grace period for your initial payment up to the 10th of the month. If we do not receive your premium payment by January 10th, your child's coverage for January will be cancelled. You'll have to re-apply on the New York State of Health website. After your initial payment, we will send you a bill each month. Please call our Premium Billing department at 1-877-229-3439 with any questions or to pay by telephone.

Q.
Who do I call if I have questions?
A.

If you have questions or problems, call Member Services at 1-800-493-4647, TTY 711. We can help with:

  • Any concerns you may have about your child’s health care benefits or services
  • Answers to questions about how to get services
  • Health education information
  • Errors on the UnitedHealthcare ID card

If you have questions about premium payment, please call toll-free 1-877-229-3439.  Please have the UnitedHealthcare ID card available when you call so we can help you sooner.

Q.
How do I use the ID card?
A.

You will receive an ID card for your child after you enroll that shows that your child is a member of the UnitedHealthcare Community Plan for Kids program. Carry the ID card with you at all times and show the ID card each time your child receives medical care. Showing your card makes sure that medical bills for covered services are not sent to you.

If you have questions about premium payment, please call toll-free 1-877-229-3439. Please have the UnitedHealthcare ID card available when you call so we can help you sooner.

Q.
What if I need an interpreter?
A.

We can help you if you do not speak or understand English. If you need an interpreter, please call Member Services at 1-800-493-4647, TTY 711, and notify our representatives what languages you speak.

Q.
What if I don’t pay the premium for my child?
A.

Some people have to pay a premium for their children enrolled in UnitedHealthcare Community Plan for Kids. If you have to pay a premium, it is important that you pay the premium for each child enrolled with UnitedHealthcare by the first of each month. If you do not pay the premium by the end of the grace period, your child will be disenrolled from UnitedHealthcare Community Plan for Kids. If you have questions regarding whether or not UnitedHealthcare has received your premium payment, call toll -free 1-877-229-3439.

Q.
How does my child’s primary care doctor help?
A.

As an enrollee of UnitedHealthcare, you must choose a primary care doctor for your child. You may choose a different doctor for each child in your family. To help you decide what is best for you and your family, here are some definitions:

  • Family practice doctors see patients of all ages from infants to adults for general health care.
  • Internal medicine doctors (internist) treat diseases in adults. They do not do surgery or treat young children, but may treat children over the age of 16.
  • Pediatricians are doctors who care for children from birth to age 16, sometimes 18.

Your child’s primary care doctor can help you with all of your child’s health care needs and should always be a part of your child’s medical care team. To help you with your child’s medical needs, your primary care doctor and staff are available to you by telephone for advice or an appointment. He or she should:

  • Refer your child to a specialist when necessary
  • Give you advice or appointments
  • Admit your child to a hospital if medically necessary
  • Be called whenever possible if an emergency happens (unless it is life threatening. If your child is suffering from a life threatening injury or illness and you cannot call your child’s primary care doctor, call 911 or go to your nearest emergency room).
Q.
Do I need to have my child’s medical records transferred?
A.

If you choose a primary care doctor that your child has never been to before, it is important for you to have your child’s medical records transferred as soon as possible. This will help your child’s doctor provide your child with the best care possible. To transfer your child’s records, call or write your former doctor and ask him or her to send those records to your child’s new doctor.

Q.
How do I get prescriptions?
A.

You can obtain prescriptions for your child(ren) through any pharmacy that participates with Optum Rx. A list of participating pharmacies is included in the Provider Directory. Simply present your prescription and your UnitedHealthcare Community Plan Member ID card to your pharmacist. There are no copayments required for prescriptions. Certain medications may require prior authorization, check the Preferred Drug List on this website to see which items require prior authorization.

Q.
Can I use my neighborhood pharmacy?
A.

You can use any pharmacy that participates with OptumRx. You will also find the names of these pharmacies in the Provider Directory enclosed within your welcome packet. Just ask your pharmacist if they participate in the Medicaid Prescription drug program.

Q.
What should I expect as a new member of the plan?
A.

As a new member you should expect to receive your UnitedHealthcare Community Plan ID card within 14 days of joining the plan. You should also receive your new member welcome kit which includes your Member Handbook, the Provider Directory and other important information.

Additionally, we will contact you by phone to welcome you to the plan and conduct a new member orientation and a health risk assessment (HRA). The new Member Orientation is a great way to learn about the benefits available to you under the plan. UnitedHealthcare Community Plan reviews all HRAs and identifies members with chronic and long term medical conditions that we can help you manage. In some cases, you may be assigned a Case Manager who will work with you and your physician to manage your healthcare needs.

Q.
Will I have to pay any money?
A.

As a member of the UnitedHealthcare Community Plan you do not have to pay for any covered services you receive.

If you receive a bill from a provider, do not send them payment. Instead return the bill to your provider along with your UnitedHealthcare Community Plan ID number and ask your provider to bill us directly.

Q.
Can I select a different primary care doctor?
A.

Your child’s primary care doctor is important to his health care. If you are unhappy with your child’s doctor, please talk with him or her so that they know why you are unhappy. Your doctor can only correct a problem that he/she knows about.

If you feel it will be better to change to another primary care doctor, call Member Services at 1-800-493-4647, TTY 711. If you need help in finding a new doctor, Member Services will help you. After you change your child’s primary care doctors, be sure to have your child’s medical records transferred to your new doctor.

Q.
Do I need to make an appointment?
A.

Whenever possible, schedule your child’s appointments in advance. This will save you time. If you think your child has a medical problem that needs the primary care doctor’s attention quickly, make sure you tell the person who is scheduling your appointment. If you cannot keep a scheduled appointment with your child’s doctor, please call and cancel the appointment as soon as possible.

Depending on the care you need, the doctor must be able to see your child within these time limits:

  • Urgent medical or behavioral problems within 24 hours;
  • Non-urgent “sick visits” within 48-72 hours;
  • Routine, non-urgent or preventive care visits within 4 weeks; and
  • In-plan, non urgent mental health or substance abuse visits within 2 weeks.
Q.
What if I don’t remember my premium amount?
A.

Just call our Premium Billing team at 1-877-229-3439 and our Billing Representatives will assist you with questions about your account, processing your payment and general billing questions.

Questions?

Ready to get started?

Call Us:
1-888-617-8979
TTY: 711

Enrollment:
Monday - Friday 8 a.m.-8 p.m. EST.
Benefits:
Monday - Friday 8 a.m.-6 p.m. EST.

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