Child Health Plus
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.
This plan is available in the following counties: 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.
Vision, Dental and Hearing Care
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.
Home Care and Supplies
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.
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 doctor appointments.
- Provide your care team with your medical records.
- Your case manager will stay with your child throughout the medical journey.
He or she will:
- Think beyond your 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.
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.
If your child has diabetes, you may need insulin, needles, wipes and glucose strips. We cover all that and more.
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.
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.
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.
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.
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
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.
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 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.
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.
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.
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.
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.
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.
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.
Child Health Plus
Call to apply today.
Already a member?
Monday - Friday 8 a.m.-8 p.m. EST. Benefits:
Monday - Friday 8 a.m.-6 p.m. EST.
You have access to our member-only website where you can print ID cards and more.Member Website
Child Health Plus Member Handbook
Child Health Plus Member Subscriber Contract
Child Health Plus Renew Coverage