New York Child Health Plus: CHIP coverage

Last verified: June 2026

What is Child Health Plus?

Child Health Plus (also written "Child Health Plus" or CHP) is New York's separate CHIP program, authorized under Title XXI of the Social Security Act. It covers children under age 19 who are New York State residents and do not qualify for Children's Medicaid. NY DOH administers Child Health Plus through managed care plans contracted with the state.

Applications go through NY State of Health (nystateofhealth.ny.gov) or by calling 1-855-355-5777. The application also screens for Children's Medicaid eligibility — children who qualify for free Medicaid are enrolled there first; Child Health Plus covers those above Medicaid income limits up to 400% FPL.

There are no co-payments for services under Child Health Plus. Premiums apply depending on family income, with no premium at all for the lowest income levels.

Child Health Plus income limits and monthly premiums (2026)

The table below shows Child Health Plus monthly premium tiers based on 2026 federal poverty guidelines (effective for applications received on or after February 17, 2026, per NY DOH). Dollar amounts are monthly income by family size.

Source: NY DOH Child Health Plus eligibility and cost page; 2026 Child Health Plus Monthly Income Eligibility and Premiums table (effective applications received on/after 2/17/2026). For families above 400% FPL, the full premium varies by health plan. Premiums are capped at three children per family regardless of family size.

What Child Health Plus covers

Child Health Plus provides a full benefit package through contracted managed care plans. There are no co-payments for any covered service.

• Primary and preventive care — well-child visits, immunizations, and annual physicals
• Specialist care — referrals coordinated through the plan
• Dental care — routine exams, cleanings, X-rays, fillings, and extractions
• Vision care — eye exams and eyeglasses
• Mental health and substance use services
• Hospital care — inpatient and emergency room
• Prescription drugs

Benefits are delivered through managed care plans that contract with NY State of Health. The specific plans available depend on the county of residence.

Who qualifies for Child Health Plus

To be eligible, a child must be:

• Under age 19
• A resident of New York State
• Not eligible for Children's Medicaid (Child Health Plus fills the gap above Medicaid income limits)
• Not already covered by employer-sponsored insurance that meets Child Health Plus standards

Immigration status does not affect Child Health Plus eligibility. Children who are undocumented, have temporary visas, or are in other immigration categories still qualify if they meet the income and residency requirements, per NY DOH.

Families above 400% FPL can also enroll their children by paying the plan's full monthly premium — an option that exists because NY State law extends Child Health Plus beyond the standard federal CHIP upper limit. Most other states do not offer this.

What Child Health Plus covers

Child Health Plus provides a full benefit package through contracted managed care plans. There are no copayments for any covered service at any income level.

• Primary and preventive care — well-child visits, immunizations, and annual physicals
• Specialist visits and referrals coordinated through the plan
• Dental care — routine exams, cleanings, X-rays, fillings, and extractions
• Vision care — eye exams and eyeglasses
• Mental health and substance use services
• Hospital care — inpatient and emergency room
• Prescription drugs
• Physical, occupational, and speech therapy
• Medical equipment when medically necessary

How New York's CHIP compares to other large states