Child Health Plus

Medicaid

The New York State Child Health Plus program offered through UnitedHealthcare is simply great health care coverage. It's for children and young adults up to age 19 who are residents of the State of New York and are not eligible for Medicaid or enrollment in or access to NYSHIP. View the list of benefits below to see all that our plan covers.

Albany, Bronx, Broome, Cayuga, Chautauqua, Chemung, Chenango, Clinton, Columbia, Essex, Fulton, Genesee, Herkimer, Jefferson, Kings, Lewis, Madison, Monroe, Nassau, New York, Niagara, Oneida, Onondaga, Ontario, Orange, Oswego, Queens, Rensselaer, Richmond, Rockland, Seneca, St. Lawrence, Suffolk, Tioga, Ulster, Warren, Wayne, and Westchester.

Benefits & Features

Well and Sick Care

Get the care your child needs to grow up healthy – or to get better if he or she is injured or sick. That includes:

  • Choice of Doctors. Find a doctor for your child from our broad network.
  • Hospitalization. You pay nothing for hospital care.
  • Medicines. There are no copays for covered drugs.
  • No Copays. You pay nothing for your child’s covered services.
  • Shots and Immunizations. Routine shots to help keep your child healthy.
  • Well Visits. We cover routine well-baby or child exams.
  • Outpatient Services. Lab tests, x-rays and other imaging are covered.

Make sure your child's sight, teeth and hearing are at their best. Benefits include:

  • Vision. Covers eye exams and glasses.
  • Dental. We cover cleanings, checkups and dental work.
  • Hearing. Screenings and therapies, if needed, are provided.

Get the medical equipment and diabetic supplies needed to manage your child's health. Benefits include:

  • Durable Medical Equipment.Your child's in-home safety equipment is covered.
  • Nurse Visits. Care after surgery or illness to recover at home.
  • Diabetic Supplies. Insulin, needles and wipes ordered by your doctor.

Sometimes you might need a little extra help using your child's health plan. For those times, you can rely on:

  • Member Services. Call 24/7 for answers about your child's benefits.
  • Nutrition Coaching. Helpful advice to improve your child's diet.
  • Grief Support. Have someone your child can talk to in difficult times.

Asthma and COPD Care

Does your child have asthma or respiratory allergies? If so, you are on watch for a breathing emergency.

Your child can be assigned a nurse with special knowledge of childhood breathing problems. Your child's nurse will:

  • Get to know your child.
  • Learn his or her triggers and activities.
  • Develop a customized treatment plan.

So your child may have:

  • Reduced symptoms.
  • Less need for emergency care.

Case Management

Does your child have a serious health problem? If so, and your child qualifies, we offer case managers that can:

  • Explain medical terms in plain language.
  • Coordinate your child's doctor appointments.
  • Provide your care team with your child's medical records.

Your case manager will stay with your child throughout the medical journey. He or she will:

  • Think beyond your child's medical needs.
  • Make sure you have support at home.

So your child can focus on getting better.

Choice of Doctor

Your child gets a primary care physician (PCP), who is his or her main doctor. Use the Doctor Lookup tool to see if your child's doctor is in our network.

If your child doesn't have a doctor or if this doctor is not in our network, we can help you find a new one close to you.

Your PCP is your main doctor for:

  • Preventive care.
  • Treatment if you are sick or injured.
  • Referrals to specialists for certain conditions.

Your child can see a specialist without a referral.

Dental Care

Checkups and emergency care are covered.

Exams and cleanings every six months help your child develop strong and healthy teeth and gums. If there is a dental problem that needs to be fixed, that's covered as well.

Diabetic Supplies

If your child has diabetes, you may need insulin, needles, wipes and glucose strips.

Our plan also steps up with services to help you manage your child's diabetes, including:

  • Classes on keeping diabetes in control.
  • Coordinating doctor care.
  • Nutrition and diet.

Durable Medical Equipment

Your child's health and safety at home are important.

Our plan covers medical equipment ordered by your doctor or case manager for your child. This can include supplies like:

  • Diabetic supplies.
  • Hospital beds.
  • Wheelchairs or walkers. 

Grief Support

A loss can take many different forms. And you may get lots of suggestions on how to help your child. Grieving is part of the healing process.

If a recent loss has made your child sad or unhappy, help is available. Our plan offers counseling and support to your child during the grieving process. Our team will work with you to find a counselor or program to help your child adjust to the loss.

Hearing Care

Trouble hearing can affect your child's everyday life in many ways. Our plan includes services and support to help protect your child's hearing.

Our plan covers:

  • Exams, therapy and tests.
  • Hearing aids.

Hospitalization

This plan pays for all your child's expenses related to a hospital stay.

Hospitalization coverage includes:

  • Nursing care.
  • Room and board.
  • Supplies and equipment.
  • Treatment and therapies.
  • Diagnostic tests and exams.

And after your child leaves the hospital, we watch over his or her care. We make sure your child gets follow-up care to continue healing at home.

In-Home Care

After surgery or a serious illness your child may need extra care and services to recover. This may include an in-home medical visit to check on how well your child is healing.

With approval, our plan covers:

  • Medical equipment like hospital beds, walkers or wheelchairs.
  • Disposable medical supplies.
  • In-home medical visit

Medicines

There are no copays for covered drugs.

We also cover over-the-counter medicines with a written order from your child's doctor.

And we make getting your child's medicine easy. You can fill his or her prescriptions at:

  • Local pharmacies.
  • Services that deliver right to your door.

Member Services

Sometimes you might need a little help understanding your health care options. With us, you have someone you can call 24/7. We’ll answer your questions simply and completely.

We can also help you find:

  • Home care providers.
  • Dentists and vision providers.
  • Adult Day Health Centers.

Mental Health

Mental health is as important as physical health. That's why we have coverage for both.

Required care is 100% covered with no copay. This includes:

  • Behavioral therapy.
  • Substance abuse treatment.
  • Medications.

No Copays

You will not have a copayment for your child's care and services covered by our plan.

That means you will pay nothing for covered services, including:

  • Preventive care.
  • Annual checkups.
  • Prescription drugs covered by the plan.
  • Routine dental or vision care.

Nurse Visit

Your child may need continued care after leaving the hospital or urgent care.

If your child's health is at risk after a serious illness, surgery or injury, a nurse will visit your child to:

  • Provide medical care for your child.
  • Answer your questions and concerns.

Nutrition Coaching

Healthy eating goes a long way to helping your child grow and stay at his or her best. A nutritionist can meet with you to review your child's eating habits and food choices.

You'll come away with new ideas to:

  • Making good choices for quick meals and snacks.
  • Preparing healthy meals on a budget.

Outpatient Services

Knowing what's wrong and finding it early can make all the difference for your child.

Our plan covers:

  • Labs and testing.
  • X-rays, scans and other imaging.

We'll help you get the information needed to help improve your child be his or her best.

Respite Care

Caring for a child with special health needs is an act of love.

It can also be physically and emotionally exhausting. We can provide respite care to give you a rest.

Shots and Immunizations

Routine shots help keep your child healthy.

So, our plan covers:

  • Recommended shots and vaccines.
  • Diagnostic tests and exams.

Vision Care

See life more clearly with routine eye exams and glasses, if needed.

We also include:

  • Prescription lenses.
  • Medicaid approved frames.
  • New eyeglasses every two years.

This benefit is offered by March Vision Care.

Well Child Visits

Well visits with your doctor can help your child stay healthy. These visits can catch health problems early, so they can be treated.

Preventive services include:

  • Annual checkups for children.
  • Well-baby care.
  • Routine shots and tests.

There are no copayments for preventive care.

Member Resources

View Available Resources