Child Health Plus is New York's Children's Health Insurance Program (CHIP), and in 2026 it is one of the most generous in the country. New York covers children from birth through age 18 whose family income is above the Medicaid line, all the way up to 400% of the Federal Poverty Level ($132,000 for a family of four in 2026). Children in families below 222% FPL pay nothing, and families in higher income bands pay a flat monthly premium per child, from $15 to $60 in 2026. There is no asset test, and New York accepts Child Health Plus applications every month of the year.
New York is a Medicaid expansion state, so adults earning up to 138% FPL ($22,025 for one person in 2026) can enroll in Medicaid, and no ACA coverage gap exists for New York adults. Children are handled separately. New York Medicaid covers infants up to 223% FPL and children ages 1 through 18 up to 154% FPL in 2026. Child Health Plus picks up where children's Medicaid stops. This page explains who qualifies, the 2026 income limits by household size, the premium tiers, the documents to gather, and what to do after a denial.
Quick Answer: Does My Child Qualify for New York Child Health Plus in 2026?
Yes. Child Health Plus covers New York children under 19 in families earning up to 400% of the Federal Poverty Level in 2026 ($132,000 for a family of four), with no asset test. Children below 222% FPL pay no premium; higher tiers pay $15 to $60 per child per month in 2026. Children must live in New York, not qualify for Medicaid, and not have other coverage. Apply year-round at NY State of Health.
Child Health Plus Income Limits by Household Size in New York (2026)
New York Child Health Plus measures income with Modified Adjusted Gross Income (MAGI), the same method used for Medicaid and the ACA Marketplace. MAGI starts with adjusted gross income from the federal tax return and adds back untaxed foreign income, tax-exempt interest, and the untaxed portion of Social Security benefits. Household composition follows tax-filing rules, so family size usually means the tax filer, the spouse, and everyone claimed as a tax dependent. The 2026 Federal Poverty Level is $15,960 for one person plus $5,680 for each additional person, and Child Health Plus uses that 2026 figure.
For a family of four, New York Child Health Plus has no premium up to $73,260 a year (222% FPL in 2026), and then charges $15 per child up to 250% FPL ($82,500), $30 per child up to 300% ($99,000), $45 per child up to 350% ($115,500), and $60 per child up to 400% ($132,000). The table above shows the 400% ceiling for every household size in 2026. Because a 5-point MAGI income disregard applies in most income tests, a family slightly over a line on paper may still screen under it. Families above the ceiling can still buy Child Health Plus at the full premium.
Child Health Plus and New York Medicaid: Which Program Covers My Child in 2026?
New York sends a child to Medicaid before Child Health Plus whenever the family income is low enough. In 2026, New York Medicaid covers infants under age 1 up to 223% FPL and children ages 1 through 18 up to 154% FPL, which is $50,820 a year for a family of four. Parents and caretaker relatives qualify for Medicaid up to 138% FPL in 2026, and adults without children qualify at the same 138% FPL level because New York expanded Medicaid. A child whose family income sits above the Medicaid line but at or below 400% FPL is placed in Child Health Plus. A single NY State of Health application checks both programs, so you do not have to choose one first.
How to Apply for Child Health Plus in New York
New York accepts Child Health Plus applications year-round through NY State of Health, the state's official health insurance marketplace. You can apply online at nystateofhealth.ny.gov, by phone at 1-855-355-5777, or with free help from a navigator or enrollment assister near you. The state eligibility system checks the child for Medicaid first, then for Child Health Plus, and then shows the health plans available in your county. Child Health Plus uses a first-of-the-month start: an application received by the 15th generally starts coverage on the first day of the next month, and a later application starts the month after that.
Documents Needed to Apply for Child Health Plus in New York
New York Child Health Plus applicants usually need only a few documents because NY State of Health checks income, citizenship, and residency against federal and state databases. When the databases do not match what you reported, the state sends a notice that lists the proof it needs and a deadline to send it. Keep copies of everything you submit. Parents who are not applying for themselves do not need to provide their own immigration status or Social Security number to get coverage for an eligible child.
- Social Security number for each child who has one
- Proof of New York residency: lease, utility bill, or official mail
- Proof of 2026 household income: pay stubs, tax return, W-2 or 1099 forms
- Proof of each child's age: birth certificate, passport, or school record
- Immigration documents for non-citizen children, if applicable
- Details of any other health insurance the child has
Is New York a Medicaid Expansion State? What It Means for Child Health Plus
New York is a Medicaid expansion state, so the ACA gap that affects adults in the 10 non-expansion states (Alabama, Florida, Georgia, Kansas, Mississippi, South Carolina, Tennessee, Texas, Wisconsin, and Wyoming) does not exist in New York. Adults earning up to 138% FPL ($22,025 for one person in 2026) qualify for Medicaid. Child Health Plus is a separate children's program under Title XXI of the Social Security Act, and its 400% FPL ceiling in 2026 is far above the adult Medicaid line. Expansion adults face a federal work requirement that must start no later than January 1, 2027, unless the state receives a good-faith exemption, but that rule applies to adults ages 19 to 64, not to children covered by Child Health Plus.
Child Health Plus and Immigration Status in New York After October 1, 2026
New York has long said children may qualify for Child Health Plus regardless of immigration status, and a parent's status does not affect a child's application. A federal change took effect on October 1, 2026: full Medicaid and CHIP with federal matching funds are now limited to citizens and nationals, green card holders, Cuban and Haitian entrants, and citizens of Micronesia, the Marshall Islands, and Palau. Refugees, asylees, parolees, and other immigrants without a green card generally no longer qualify for the federally funded programs. Coverage that a state pays for with only its own money is a state-funded program, not Medicaid, and the state has said it plans to keep covering people affected, though details may change. Confirm your child's status with NY State of Health at 1-855-355-5777 before assuming either result.
Common Reasons Child Health Plus Applications Get Denied in New York
New York denials of Child Health Plus mostly come down to a short list of causes. The child may qualify for Medicaid instead, which means the case is moved rather than closed. Household income may sit above the 400% FPL ceiling for 2026 ($132,000 for a family of four), which leaves the full-premium option. The child may be 19 or older, or may already have other health insurance. Paperwork is the other big cause: if NY State of Health asks for proof and it is not returned by the deadline in the notice, the application can be denied even though the child is eligible.
- Household income above 400% FPL ($132,000 for a family of four in 2026)
- Child qualifies for Medicaid instead (case is moved to Medicaid)
- Child is 19 or older
- Child already has other health insurance
- Requested proof not returned by the notice deadline
How to Appeal a Child Health Plus Denial in New York
New York gives every Child Health Plus applicant the right to appeal an eligibility decision. The denial notice from NY State of Health states the reason, the appeal deadline, and where to send the request, so read it first and keep it. Appeals are heard by a hearing officer, often by telephone, and you may bring a lawyer, a legal aid advocate, or a family member. Calling NY State of Health at 1-855-355-5777 before you file can resolve many cases quickly, especially when the cause is missing paperwork or a data mismatch rather than income. Medicaid decisions made by local social services can go to a fair hearing run by the Office of Temporary and Disability Assistance (otda.ny.gov).
What New York Child Health Plus Covers in 2026
Child Health Plus gives New York children a comprehensive benefit package delivered through managed care health plans. Covered services include doctor visits, well-child care and immunizations, hospital and emergency care, prescription drugs, mental health and substance use treatment, dental and vision care including eyeglasses, hearing and speech services, and durable medical equipment. Families pay no copayments for covered services on Child Health Plus, only the monthly premium for their income band in 2026. Because Child Health Plus counts as minimum essential coverage under the ACA, enrolling a child satisfies the federal coverage standard for that child.
Frequently Asked Questions
What is the Child Health Plus income limit for a family of 4 in New York in 2026?
A family of four can earn up to $132,000 a year in 2026 (400% of the $33,000 Federal Poverty Level) and still qualify for New York Child Health Plus. Families earning up to $73,260 (222% FPL) pay no premium. Above that, the premium is $15 to $60 per child per month in 2026, with a family maximum. Children who qualify for Medicaid at 154% FPL ($50,820) or less are enrolled in Medicaid instead.
What counts as income for Child Health Plus (MAGI)?
New York Child Health Plus uses Modified Adjusted Gross Income (MAGI). MAGI starts with adjusted gross income on the federal tax return and adds untaxed Social Security benefits, tax-exempt interest, and untaxed foreign income. Household composition follows tax-filing rules, so family size includes the filer, the spouse, and tax dependents. Child Health Plus has no asset test, so savings and property are not counted.
What documents do I need to apply for Child Health Plus in New York?
Gather each child's Social Security number if the child has one, proof of New York residency, proof of 2026 household income such as pay stubs or a tax return, proof of each child's age, and immigration documents for children who are not citizens. NY State of Health checks many facts automatically and sends a notice with a deadline if it needs more proof.
What happens if my Child Health Plus application is denied?
Read the denial notice, which gives the reason and the appeal deadline. Call NY State of Health at 1-855-355-5777 to confirm whether the cause is income, a Medicaid match, or missing paperwork. You can then file an appeal and ask for a hearing, with a lawyer or legal aid advocate if you wish. If income is above 400% FPL in 2026, the full-premium option remains.
Can my child work and still qualify for Child Health Plus?
Yes. A dependent child's job does not by itself disqualify the child. Under MAGI rules, a child's income counts toward the household only if the child must file a tax return, and even then the family total must stay at or below 400% FPL ($132,000 for a family of four in 2026) to qualify. Report all household income on the application.
Is New York a Medicaid expansion state?
Yes. New York expanded Medicaid, so adults earning up to 138% FPL ($22,025 for one person in 2026) qualify, and no ACA coverage gap exists for New York adults. Child Health Plus is separate: it covers children under 19 up to 400% FPL in 2026 and is not affected by the adult expansion or the adult work requirement due by January 1, 2027.
How long does the Child Health Plus application take?
Many applications through NY State of Health receive an instant eligibility result, and cases needing proof are held until documents arrive. Coverage starts on the first day of a month: an application received by the 15th generally starts the first day of the next month, and a later application starts the month after. Child Health Plus has no open enrollment window, so you can apply any month in 2026.
Does an immigrant child qualify for Child Health Plus in 2026?
New York has said children may qualify for Child Health Plus regardless of immigration status. Since October 1, 2026, federally funded Medicaid and CHIP are limited to citizens, green card holders, Cuban and Haitian entrants, and citizens of Micronesia, the Marshall Islands, and Palau. State-funded coverage is not Medicaid. Call NY State of Health at 1-855-355-5777 to confirm your child's options.
