Got questions about your health plan? WellCare wants to make it easy for you to find answers. Below are some commonly asked questions from our members along with the respective answers. If you have a question that isn’t listed here, or if you need any information regarding your WellCare health plan coverage, please call our Customer Service Department or contact us.

1) What Is Child Health Plus?

New York State has a health insurance plan for kids, called Child Health Plus. Depending on your family’s income, your child may be eligible to join either Child Health Plus A (formerly Children’s Medicaid) or Child Health Plus B. Both Child Health Plus A and B are available through healthcare providers throughout the state, like WellCare. Enrolling in Child Health Plus is easy.

2) Who Is Eligible?

To be eligible for either Child Health Plus A or B, children must be under the age of 19 and be residents of New York State. Whether a child qualifies for Child Health Plus A or Child Health Plus B depends on gross family income. Children who are not eligible for Child Health Plus A can enroll in Child Health Plus B if they don’t already have health insurance and are not eligible for coverage under the public employees’ state health benefits plan.

3) What Does It Cost?

There is no monthly premium for families whose income is less than 1.6 times the poverty level. That's about $460 a week for a three-person family, about $560 a week for a family of four. Families with somewhat higher incomes pay a monthly premium of $9 or $15 per child, depending on their income and family size. For larger families, the monthly fee is capped at three children. If the family's income is more than 2.5 times the poverty level, they pay the full monthly premium charged by the health plan. There are no co-payments for services under Child Health Plus, so you don't have to pay anything when your child receives care through these plans.

4) What Benefits Can I Get for My Kids?

• Well-child care
• Physical exams
• Immunizations
• Diagnosis and treatment of illness and injury
• X-ray and lab tests
• Outpatient surgery
• Emergency care
• Prescription and non-prescription drugs if ordered
• Inpatient hospital medical or surgical care
• Short-term therapeutic outpatient services (chemotherapy, hemodialysis)
• Limited inpatient and outpatient treatment for alcoholism and substance abuse, and mental health
• Dental care
• Vision care
• Speech and hearing care
• Durable medical equipment
• Emergency ambulance transportation to a hospital
• Hospice

5) Where Do My Kids Go for Healthcare?

If your child is enrolled in Child Health Plus A, you may be required to enroll in a managed care plan, or you may bring your child to any provider who accepts Child Health Plus A. If your child is enrolled in Child Health Plus B, you will be given a list of providers near you. The provider may be a single doctor, group practice of several doctors, or community health center. If it is a group practice, you will be asked to choose a doctor for your child. Either way, you will be getting the personal healthcare that your child deserves!

6) How Do I Apply?

Call this toll-free number: 1-800-698-4KIDS (1-800-698-4543), and ask about Child Health Plus (if you are hearing impaired, call the TTY number, 1-877-898-5849.) If you are eligible for Child Health Plus A (see “Who is eligible?”), you can ask WellCare to help you enroll. Or you can enroll through your local Department of Social Services. If your income is above Child Health Plus A levels, you can enroll with a Child Health Plus B insurer directly. Each insurer offers healthcare through many providers. The insurer will send you an application and give you a list of providers in your area.

If you would like someone to assist you in applying for either Child Health Plus A or Child Health Plus B, there are enrollers in your community who can help. These enrollers will help you fill out the application, collect the necessary documents, and select a health plan. In many cases, assistance is available during evenings and weekends. To learn the nearest location where application assistance is available, please call 1-800-698-4KIDS (1-800-698-4543).