October 10, 2016

Health Insurance

health insurance for familiesHealth Insurance Resources in NYS

Medicaid and CHIP insure more than 50% of US children. Children in the greater Rochester area are no exception. Efforts to keep our children insured and under regular care of their primary care doctors is paramount in our goal to help kids THRIVE!

Under the Affordable Care Act, New York State residents are able to shop around for insurance carriers in the NYS DOH marketplace. The information and resources below were taken directly from the individual websites for your reference.

New York State of Health

You and your family have many new low cost, quality health insurance options available through the Individual Marketplace.

You can quickly compare health plan options and apply for assistance that could lower the cost of your health coverage. You may also qualify for health care coverage from Medicaid or Child Health Plus through the Marketplace. Anyone can apply at their website.

Website: https://nystateofhealth.ny.gov/


New York State Child Health Plus

New York State has a health insurance plan for kids, called Child Health Plus. Depending on your family’s income, your child may be eligible to join either Children’s Medicaid or Child Health Plus. Both Children’s Medicaid and Child Health Plus are available through dozens of providers throughout the state.

Call this toll-free number: 1-800-698-4KIDS (1-800-698-4543), and ask about Child Health Plus and Children’s Medicaid. If you are hearing impaired call the TTY number, 1-877-898-5849.

Informational material about New York State’s Child Health Plus program is available FREE of charge to organizations within New York State.

To request copies, please complete the order form and return or fax to:

NYS Department of Health Distribution Center
21 Simmons Lane
Menands, NY 12204
FAX: 518-465-0432

Website: http://www.health.ny.gov/health_care/child_health_plus


Child Health Plus Eligibility

To be eligible for either Children’s Medicaid or Child Health Plus, children must be under the age of 19 and be residents of New York State. Whether a child qualifies for Children’s Medicaid or Child Health Plus depends on gross family income. Children who are not eligible for Medicaid can enroll in Child Health Plus if they don’t already have health insurance and are not eligible for coverage under the public employees’ state health benefits plan. Some children who were covered by employer-based health insurance within the past six months may be subject to a waiting period before they can be enrolled in Child Health Plus. Determining whether your child is subject to a waiting period will depend on your household income and the reason your child(ren) lost employer-based coverage.

There is no monthly premium for families whose income is less than 1.6 times the poverty level. That’s about $600 a week for a three-person family, about $724 a week for a family of four. Families with somewhat higher incomes pay a monthly premium of $9, $15, $30, $45, or $60 per child per month, depending on their income and family size. For larger families, the monthly fee is capped at three children. If the family’s income is more than 4 times the poverty level, they pay the full monthly premium charged by the health plan. There are no co-payments for services under Child Health Plus, so you don’t have to pay anything when your child receives care through these plans.

Website: http://www.health.ny.gov/health_care/child_health_plus/eligibility_and_cost.htm


Facilitated Enrollment

Facilitated Enrollment is a New York State grant funded program whose purpose is to assist families with applications for health insurance.  The goal of the agency is to enroll children and families in appropriate health insurance programs.  Facilitated Enrollers assist children and families without medical insurance as well as those who need to re-certify for Child and Family Health Plus and Medicaid.

Address:  1099 Jay Street, Building J, Rochester, NY 14611
Phone:  (585) 613-7662
Fax:  (585 613-7671

Website:  www.ccsi.org/facilitatedenrollment

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