NEWS
from...
Assemblyman
Nelson L. Castro
Dear Neighbor,
You can now apply for the Family Health Plus Program, which will allow New Yorkers,
aged 19 to 64, to receive quality health care.
The New York Legislature created this program which provides free health insurance for
those with no coverage, but whose income is too high to qualify for Medicaid.
If you think Family Health Plus is right for you, or if you have any other questions, contact
the state Family Health Plus hotline at 1-877-9-FHPLUS (1-877-934-7587), or contact my
office. Many health centers, hospitals, health care providers and community groups can
also help you to get information and apply.
Sincerely,
Nelson L. Castro
Member of Assembly
Family Health Plus...
Making Health Care Available to All Working Families
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 $37,200
or less, and a childless family of two with an annual income of $13,050 or less can receive health
insurance. There are limits on the amount of assets or resources (such as a bank account) that
you can have and still be eligible to enroll in Family Health Plus. The amount of income and
assets/resources you and your family can have and still be eligible for Family Health Plus depends
on how many people are in your family.
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 and resource levels for participants.
The income and resource levels are different for people without children and families with children.
The income and resource 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
are provided by a managed care plan, and 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)
-
hospice care
-
family planning and reproductive health services
Maximum Annual Income
(Total or “gross” income before taxes or other deductions)
Family
Size
Single or
Married Adult
(not living with children
under 21)
Single or
Married Parent
(living with at least
one child under 21)
Resource
Level
1
$10,400
$13,050
2
$14,000
$21,000
$19,200
3
$26,400
$22,200
4
$31,800
$25,050
5
$37,200
$27,900
6
$42,600
$30,750
7
$48,000
$33,600
