Q: When do I receive my membership card?
A: After you enroll, we'll send you a welcome letter. Your Health Plus Membership Card should arrive within 14 days. Your card has your PCP's (primary care provider's) name and phone number. If it's wrong, call us right away. Carry your Health Plus Membership Card at all times and show it each time you go for care. If you need care before the card comes, your welcome letter is proof that you are a member.
Back to Top
Q: When do I start coverage?
A: If your child's completed application and payment (if required) is received by the 20th of the month, coverage will be effective on the first day of the next month. If your child's completed application and payment is received after the 20th of the month, your child's coverage will not be effective until the following month.
For example:
If we received your child's application with payment on September 18th and it is approved - Coverage will be effective October 1st.
If we received your child's application with payment on September 22th and it is approved - Coverage will be effective November 1st.
Back to Top
Q: What is Presumptive Eligibility?
A: Even if you do not have all of the required documents, such as proof of the child's age, proof of residence in New York State, and proof of household income, when you submit a completed application, your child(ren) may be enrolled in the Child Health Plus/Health Plus program for 60 days. This is called presumptive eligibility. You MUST give us the required documents of proof before the end of the presumptive eligibility period or your child(ren) will be disenrolled after 60 days of coverage.
Back to Top
Q: How do I get started?
A: Health Plus offers monthly informational gatherings for members who want to learn how to get healthcare and services provided by Health Plus. These gatherings are currently offered at Health Plus offices and other community sites in Brooklyn, Bronx, Manhattan, Queens and Staten Island. If you are interested in joining us, call Health Plus at (800) 300-8181 for the location and time.
Back to Top
Q: Whom do I call if I have a question or problem?
A: Call our Member Services Office at (800) 300-8181 Monday through Friday from 8am to 8pm, Saturdays from 9am-5pm and Sundays from 12noon to 4pm. Call if you have any problem, or questions about the plan.
Back to Top
Q: What do I do in an emergency?
A: If you have an urgent medical need or questions, call our 24-hour Medical Hotline at (800) 437-7587. In the case of a life-threatening emergency, call 911 or go to the nearest hospital emergency room. If you have an urgent need for Mental Health, Alcohol or Substance Abuse, services, call our Behavioral Health Hotline at (866) 223-9500.
Back to Top
Q: How do I receive urgent care?
A: Call your Primary Care Doctor for instructions about how to receive urgent care. The number is listed on your Health Plus Membership Card.
Back to Top
Q: How do I receive routine care?
A: Call your Primary Care Doctor for an appointment for routine medical care. For a first visit for Mental Health, Alcohol and Substance Abuse services, you can go directly to any provider in our network. If you need help finding a Mental Health, Alcohol or Substance Abuse provider, call Member Services at (800) 300-8181. The Behavioral Health Hotline at (866) 223-9500 can also help you find a provider and make and appointment.
Back to Top
Q: What if I need to see a specialist?
A: Your Primary Care Physician will refer you to a specialist in the Health Plus network. If you need specialist services that are not available from a Health Plus provider, your physician will refer you to a non-participating specialist. In this case, our Health Services Office will call you to inform you of the date, time, and location of your appointment.
Back to Top
Q: How do I get prescriptions filled?
A: You must get your prescriptions filled at a pharmacy listed in the Health Plus Provider Directory. Prescription and covered over the counter items must be in the State formulary and ordered a Health Plus provider.
Back to Top
Q: What if I join and then decide I want to leave the plan?
A: You can disenroll at any time by calling Member Services at (800) 300-8181. Also, you could become ineligible for Health Plus. You or your child may have to leave Health Plus if you or your child:
- Moves out of the Health Plus service area
- Changes to another managed care plan, or
- Joins an HMO or other insurance plan through work, or
- Your child is also enrolled in Medicaid
- Your child reached age of 19
- Your child was presumptively enrolled and you did not submit necessary documents to complete his/her application for Child Health Plus
- You do not recertify by submitting an application and other necessary documentation prior to the child's anniversary date
- Failed to pay premium, if you are required to pay
Back to Top
Q: How do I get Dental care for my child?
A: Dental Services are available for Child Health Plus Members:
Your children can get:
- Routine Dental Care - exams, x-rays, routine dental surgery
- Preventive Dental Care - cleaning
- Emergency Dental Care
Members receive a separate Dental Membership Card. Please show this card whenever you go to the dentist. Members can call Dental Member Services at (800) 468-9868 to choose a dentist or to see if their current dentist participates in the Health Plus network.
Back to Top
Q: What happens if I don't recertify and/or renew my coverage on time?
A: Every year, you must resubmit an application to us so that we can determine whether you still meet the eligibility requirements. This process is called "recertification" or "renewal." All of the children in your family covered will have the same recertification date. You must recertify once each year. However, if you apply for coverage for an additional child, you must recertify all children at that time, so that all children in your family will recertify once each year on the same date.
If you do not recertify by submitting an application and other necessary documentation prior to your child's anniversary date, your child will be disenrolled from Health Plus at midnight on the last day of the twelfth month of coverage. Please contact us if you don’t receive a recertification application within 45 days of your child's recertification date.
If you have any questions, please call the Health Plus Member Services Department at (800) 300-8181 and a representative will assist you.
Back to Top
What is Health Plus?
Home