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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, Dutchess, Erie, 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.
After December 31, 2013, you can no longer apply for Family Health Plus. Throughout 2014, existing Family Health Plus members will be asked to complete a renewal form that includes information on your household income, your age and residency, and status of other insurance. This is called the renewal or recertification process. New York State has to collect this information to determine if you are still eligible for New York State sponsored health insurance. Prior to your renewal date, you will receive a letter from New York State Department of Health with instructions of what you need to do.
It is very important that you complete your renewal and return it promptly to keep your coverage active. UnitedHealthcare Community Plan will send you a reminder when it’s time to renew. In some counties, you can renew by telephone by calling the New York State of Health Enrollment Center. Keeping your healthcare coverage active is an important part of staying healthy.
Effective immediately, UnitedHealthcare’s Child Health Plus plan includes coverage for the following:
- Point-of-care Tests: Point-of-Care COVID-19 testing without limitation, including for purposes of travel, and school/work purposes, with no cost-sharing.
- At Home Tests: Two FDA-authorized COVID-19 test kits, per week, with no cost-sharing. Covered “at home” test kits must be authorized by the FDA for use in both symptomatic and asymptomatic patients and allow for self-collection without medical observation.
This guidance shall remain in effect for the duration of the Public Health Emergency as defined by the U.S. Department of Health and Human Services.
UnitedHealthcare continues to partner with state and local public health departments, following guidance and protocols appropriate to our members that are provided by the U.S. Centers for Disease Control and Prevention (CDC), and state and local public health departments that are appropriate for our members. Please review the UnitedHealthcare Coronavirus (COVID-19) Information. To learn more, go to CDC.gov.
COVID-19 NY State PPE Fee Guidance
The New York State Department of Financial Services (DFS) recently issued guidance stating that care providers should not charge members additional fees for items such as personal protective equipment (PPE). DFS expects New York care providers to refund any of these charges paid by the member that were more than the member’s financial responsibility on a claim. If you have questions, you may contact your provider or call the number on the back of your card for assistance with filing a complaint.
Find providers and coverage for this plan.
Search for doctors, hospitals and specialists.
Find medications covered by this plan.
Find a pharmacy near you.
Find a dentist near you.
Benefits & Features
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 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.
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.
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.
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
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 Monday – Friday 8 a.m. – 6 p.m. EST. 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 Member Handbook
Child Health Plus Member Subscriber
Child Health Plus Renew Coverage
Assignment of Benefits Form
NY Medicaid Member Notification PCP Referral Letter
National Flu Campaign Questions and Answers
Clinical Practice Guidelines
UnitedHealthcare Community Plan has practice guidelines that help providers make healthcare decisions. These guidelines come from nationally recognized sources. UnitedHealthcare Community Plan has practice guidelines for preventive health and other health conditions.
Call our Member Services at 1-800-493-4647 (TTY: 711) to request a printed copy.
Information about Enterovirus D68
Emergency Services and "Surprise" Bills
Information on Emergency Services and "Surprise" Bills
Specialty Referral Requirements
Member Newsletters 2016 - Current
Member Newsletters Prior to 2016
Medicaid Managed Care
This link is being made available so that you may obtain information from a third-party website. This link is provided solely as a convenience and is not an endorsement of the content of the third-party website or any products or services offered on that website. We are not responsible for the products or services offered or the content on any linked website or any link contained in a linked website. We do not make any representations regarding the quality of products or services offered, or the content or accuracy of the materials on such websites.