What is Family Health Plus?

Family Health Plus provides free health insurance for working lower-income uninsured adults. For example, a family of five (one or two adults, with children) with an annual income of $33,045 or less, and a childless family of two with an annual income of $12,490 or less can receive health insurance.

The program is modeled after the Child Health Plus Program. Family Health Plus ensures that the adult family members, as well as their children, are able to receive quality health care in New York State.

See the chart to find out if you qualify for Family Health Plus.

Can I drop my health insurance to join this program?

No. Family Health Plus is only for those who do not already have health insurance.

Who can join Family Health Plus?

The chart below shows the income levels for participants. Personal savings or other assets are exempt from eligibility determinations.

The income levels are different for people without children and families with children. The income levels change according to family size. “Income” means total or “gross” income before taxes or other deductions.

How is the coverage provided?

Family Health Plus is provided by managed care plans. This will help parents and children join the same plans and receive the same quality health care. Coverage will begin when you have been determined eligible and have enrolled in a managed care plan that offers Family Health Plus. If there is no Family Health Plus managed care plan in your area, similar insurance coverage providing the same benefits will be made available.

How do I enroll in Family Health Plus?

Many health centers, hospitals, health care providers and community groups can help you apply for Family Health Plus.

Just like Child Health Plus, enrollment “facilitators” will be located statewide in communities to help people enroll and to answer questions. You can also apply through your local social services offices. When you are enrolled in the program, you will have to recertify every year. You can do that through the mail.

How much does it cost to join?

Family Health Plus is free for people who qualify. If you work, but your income is low enough to qualify, New York State will pay the whole premium for this health coverage (with help from the federal and local governments).

What does Family Health Plus cover?

Family Health Plus provides a comprehensive package of benefits similar to Child Health Plus. Services will be provided by a managed care plan, and will include:

• physician services;
• inpatient and outpatient hospital care;
• prescription drugs and smoking cessation products;
• lab tests and x-rays;
• vision, speech and hearing services;
• rehabilitative services (limited);
• durable medical equipment;
• emergency room and emergency ambulance services;
• drug, alcohol and mental health treatment (some limits apply);
• diabetic supplies and equipment;
• radiation therapy, chemotherapy and hemodialysis;
• dental services (if offered by the participating plan); and
• hospice care.