Health Benefits

Other Health Benefits: Changes under COVID-19

T + T

Child Health Plus

QUALIFYING FOR AND ENROLLING IN CHILD HEALTH PLUS

Eligibility and enrollment procedures for Child Health Plus have not changed. Children eligible for Child Health Plus can enroll year-round, as usual. Go to https://www.dfs.ny.gov/reports_and_publications/press_releases/pr202003161 for more information.

For assistance with applying on the Marketplace, contact the Community Service Society of New York, which is a Navigator agency, at 888-614-5400.

RENEWAL PROCEDURES

For New Yorkers currently enrolled in Child Health Plus and have a coverage end date of March 31, 2022, their coverage will be extended for an additional 12-month period.

IMPACT OF COVID-19 CASH AID ON ELIGIBILITY

For details on how the CARES Act Economic Impact payments (EIP), the American Rescue Plan Act payments, and Pandemic Unemployment Compensation affects benefit eligibility, see HERE.

No Cost Sharing for COVID-19 Testing

There is no cost-sharing for COVID-19 testing for individuals enrolled in Child Health Plus.

Effective January 15, 2022, CHP insurers must cover either at-home antigen covid tests per member per month at no cost to the member. If the plan has a network in place for these tests, the plan will pay up to $12/test (i.e., $12 for one test, $24 for a pack of 2 tests). If they don’t have a network in place to supply the tests, they will have to reimburse the full cost of the tests (i.e., if they charge $35 for a box of 2, that will be covered). Plans can pay for the cost up-front or reimburse you.

There is no limit to the number of tests (at-home or lab-based) that a plan will cover per month if they are ordered by a health care provider following an assessment.

Essential Plan

QUALIFYING FOR AND ENROLLING IN ESSENTIAL PLAN

Eligibility and enrollment procedures for the Essential Plan have not changed.
Individuals eligible for the Essential Plan can enroll year-round, as usual. Go to https://www.dfs.ny.gov/reports_and_publications/press_releases/pr202003161 for more information.

For assistance with applying on the Marketplace, contact the Community Service Society of New York, which is a Navigator agency, at 888-614-5400.

RENEWAL PROCEDURES

For New Yorkers currently enrolled in the Essential Plan and have a coverage end date of March 31, 2022, their coverage will be extended for an additional 12-month period, as long as they remain age-eligible and do not have Medicare.

HOW COVID-19 CASH AID IMPACTS THE ESSENTIAL PLAN

For details on how the CARES Act Economic Impact payments (EIP), the American Rescue Plan Act payments, and Pandemic Unemployment Compensation affects benefit eligibility, see HERE.

Medicaid Buy-In for Working People with Disabilities (MBI-WPD)

LOST JOB DURING COVID-19 EMERGENCY

Typically, MBI-WPD recipients must maintain a job to stay in the program. However, MBI-WPD recipients have traditionally been allowed a six-month grace period if they became unemployed through no fault of their own and have the intent to return to work. During the COVID-19 emergency an additional six-month period will be provided, if needed, to look for new employment.

HOW COVID-19 CASH AID IMPACTS MEDICAID BUY-IN

For details on how the CARES Act Economic Impact payments (EIP), the American Rescue Plan Act payments, and Pandemic Unemployment Compensation affects benefit eligibility, see HERE.