Child Health Plus

November 14, 2019 11:19 AM

Can someone explain Child Health Plus in NYC to me?

Our household currently makes $100K but due to unemployment of one household member that's dropping by half until they can find a new job. Are we eligible? I can't figure it out. I know we may not be eligible for a subsidy but would the unsubsidized amount it be less than the $700/mo we're paying for private insurance through the workplace? The website doesn't make it clear.

Note: I know about the Child Health Plus neighborhood assistance thing, I just need some firsthand experience in making sense of it before I go to them.

posted by A god with hooves, a god with horns to Health & Fitness (3 answers total)

Best thing to do is apply -- I'm not an insurance navigator in NY so I don't know the ins and outs of the eligibility requirements, but the worst they can say is "no" and at best you'll be getting coverage for cheaper than a family MP plan. You might also contact your pediatrician, they may know what the typical full cost premium is -- or the website also has community partners listed to help folks understand the process and costs. The pediatrician will also know whether they accept Medicaid & which plans under Medicaid they are in-network with.

My guess is that Medicaid will be cheaper than MP coverage, even at full price.

Is it an option to have the kids on the employed parent's plan? That may be more expensive as well, but also may provide a better network or access to the current pediatrician, if they're not in-network with Medicaid plans.

Also, it may be important to know whether Medicaid counts current monthly income or expected yearly income for eligibility purposes. I know Illinois allows people to use the income for month of application but I'm not sure what the situation is in NY state.
posted by tivalasvegas at 12:09 PM on November 14, 2019

Ooo, I found this which seems to indicate that the full cost (for families at more than 400% of the federal poverty level) of Child Health Plus is about $190/child/mo. Chart is from 2016 so numbers will be slightly different now.
posted by tivalasvegas at 12:25 PM on November 14, 2019

Also this, from NY State of Health site. It looks like premium amounts are actually slightly different based on which plan you choose, which explains why the government sites are kinda cagey about giving folks exact numbers. But yeah, looks like you'd be paying around $200/kid/mo.
posted by tivalasvegas at 12:28 PM on November 14, 2019