Family Health Plus
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This one application can be used to apply for Child Health Plus, Family Health Plus, Medicaid, and the Family Planning Benefit Program. Based upon the information you provide you will be told which program you and/or your child(ren) are eligible for.
Please Note:This application will help you determine the kind of information that is needed to see if you are eligible for public health insurance. Although you do not have to have a personal interview to apply for public health insurance, you may request application assistance. If you need help filling out the application or need help determining what documents you need to submit, you can call 877-934-7587 or call or visit your local department of social services.
Click here for more information: What will happen when I apply?
The Access NY Health Care application is available as an Adobe Acrobat Portable Document Format file. Do you need help working with PDF Files?
| English Instructions (PDF, 281KB, 4pg.) Application (PDF, 415KB, 9pg.) Documents Needed When You Apply for Health Insurance (PDF, 259KB, 3pg.) Fact Sheet (PDF, 111KB, 1pg.) Supplement A (PDF, 147KB, 6pg.) All of the FHPlus application files in one (PDF, 610KB, 16pg.) |
Spanish Instrucciones (PDF, 2.07MB, 4pg.) Applicación (PDF, 225KB, 6pg.) Documentos Necesarios Para Solicitar Seguro médico (PDF, 154KB, 4pg.) Hoja de Hechos (PDF, 61KB, 1pg.) Suplemento A (PDF, 147KB, 6pg.) |
Do You Have Questions or Need Help Completing This Form?
CALL TOLL-FREE
For Children: 1-800-698-4543
For Adults: 1-877-9FHPLUS
ALL HELP IS FREE
(1-877-898-5849 TTY line for the hearing impaired)
