Frequently Asked Questions

What is Enroll NY?

Enroll NY is a Web-based tool that helps you find out if you are eligible for free or lost cost health insurance in New York State. It also lets you start a pre-application online and transmit your pre-application to a Facilitated Enroller who can help you apply.

What programs are available through Enroll NY?

The three programs for which you can screen and complete a pre-application are Medicaid, Family Health Plus, and Child Health Plus.

Medicaid

Medicaid is a program for New Yorkers who can't afford to pay for medical care. You may be covered by Medicaid if: you have high medical bills, you receive Supplemental Security Income (SSI) or you meet certain income, resource, age, or disability requirements.

Family Health Plus

Family Health Plus is a public health insurance program for adults age 19 to 64 who have income or resources too high to qualify for Medicaid. Family Health Plus is available to single adults, couples without children, and parents with limited income who are residents of New York State and are United States citizens or fall under one of many immigration categories. Family Health Plus provides comprehensive coverage, including prevention, primary care, hospitalization, prescriptions and other services. There are minimal co-payments for some Family Health Plus services. Health care is provided through participating managed care plans in your area.

Child Health Plus and Children’s Medicaid

Child Health Plus is a health insurance program for children in New York State. Depending on your family's income, your child may be eligible to join either Children's Medicaid or Child Health Plus . Both Children's Medicaid and Child Health Plus are available through dozens of providers throughout the state. To be eligible for either Children's Medicaid sometimes called CHP A or Child Health Plus sometimes called CHP B , children must be under the age of 19 and be residents of New York State. Whether a child qualifies for Children's Medicaid or Child Health Plus depends on gross family income. Children who are not eligible for Medicaid can enroll in Child Health Plus if they don't already have health insurance and are not eligible for coverage under the public employees' state health benefits plan.

Can I start a pre-application for other State programs through Enroll NY?

Currently Enroll NY offers pre-applications for Medicaid, Family Health Plus and Child Health Plus. In the future, Enroll NY hopes to offer online pre-applications for other publicly funded programs.

Does Enroll NY charge for this pre-application service?

No.

What is a Facilitated Enroller?

Facilitated Enrollers (FE's) are people or organizations in your community that will help you complete your pre-application and answer any questions you may have about what public health insurance programs are available to you.

What is a managed care organization?

A managed care organization is an insurance company that contracts with the state of New York to arrange and pay for your medical care.

Does Enroll NY recommend one FE over another?

No, all participating FE's listed on the site are affiliated with New York State and have been trained to help you complete the application process.

How do I determine which managed care organization is best for me?

You can find information about the managed care organizations operating in your coverage area by visiting the Web site links provided by Enroll NY.

How is my eligibility determined?

New York State establishes the eligibility rules for the Medicaid, Family Health Plus and Child Health Plus programs. An individual’s eligibility is determined by taking into consideration several things: the number of people in your household, your income, other financial resources and expenses such as child care. Eligibility also varies by type of program; Medicaid, Family Health plus and Child Health Plus. The Enroll NY eligibility calculator will indicate whether you might be eligible for one of these programs, and then you can choose to start a pre-application. As part of the pre-application, you choose a Facilitated Enroller to which Enroll NY will transmit your pre-application. Your Facilitated Enroller will help you complete the application process and will further advise you as to your eligibility.

Who will receive the information I enter into the pre-application?

The FE you choose when completing the pre-application will be the only one to receive your information.

Will my information be shared with other groups or organizations?

No, your information will only be sent to the Facilitated Enroller that you choose when completing the pre-application.

How do I know my information is secure?

Our Health Privacy Commitment

1. The pre-application you create is controlled by you.
2. You decide what information to enter into your pre-application.
3. Your information will be sent only to the Facilitated Enroller you choose.
4. We do not use your information for any commercial purposes.

Read our full Privacy Policy

What do I do if I make a mistake on my application but have already submitted it?

You will have an opportunity to review and correct any information you submitted when you speak to the FE that you choose as part of the pre-application submission process.

When should I expect to hear from a Facilitated Enroller after I submit my pre-application?

The FE you choose will receive the information you provide on the pre-application within 24 hours and will contact you within 5 business days to complete the application.

No one has contacted me? What next?

Enroll NY will provide you with the contact information the FE you select. You should contact the FE you selected directly to follow up on your application.

What supporting documentation should I have available when I talk to my Facilitated Enroller?

The required supporting documentation differs for each program. The FE you select in the application process will tell you which documents are required to complete your application. Some documents that you will need to apply for any of the programs; Birth certificate (state issued), Proof of income for any adults (18 or over) for the past 30 days. -Proof of residency (utility bill)

What if the Eligibility Calculator Says I Do Not Appear to be Eligible?

If the calculator determines that you do not appear to be eligible for Medicaid, Family Health Plus or Child Health Plus, you will be provided with a link to the New York State Department of Health website, where you can research the available programs and find a Facilitated Enroller in your area. There may be other options available for you..

What is a Head of Household (HOH)?

The Head of Household is the person filling out the pre-application for your household.

How do I determine my gross household income?

To calculate the gross income for your household add up all of the following types of income that anyone in your household receives.

• Earnings from work: (Pre tax) wages, salaries, commissions, tips overtime, self employment.
• Unearned income: Social security benefits, disability payments, unemployment payments, interest and dividends, veterans benefits, workers compensation, child support payments, alimony, rental income.
• Contributions: Money from relatives or friends, room or boarders (include money that anyone gives you each month to help meet living expenses.
• Other: Temporary (cash) assistance or Supplemental Security Income (SSI) payments, student grants or loans.

What counts as "financial resources?

Financial resources include money in the bank or credit union, stocks or bonds, mutual funds, certificates of deposit, money market accounts, 401K plans, trust funds, the cash value of life insurance, motor vehicles or property someone owns. When calculating your financial resources do not count the value of the home.