Reviewed by our dental health editorial team | Last Updated: March 2026
Thousands of Queens families fall into a gap that few people talk about: their household income is too high for Medicaid, but too low to comfortably afford private dental insurance.
For these families, Child Health Plus New York State’s version of the Children’s Health Insurance Program (CHIP) is the answer most of them don’t know exists.
Child Health Plus provides comprehensive dental coverage for children under 19 with no annual deductible and no copayments, at monthly premiums as low as $0 and capped at $60 per child, depending on income.
As of March 2026, over 6.7 million New Yorkers are enrolled in coverage through NY State of Health, including a significant portion on Child Health Plus.
Yet enrollment gaps persist because many families assume their income is too high to qualify, or that the program only covers basic care.
This guide explains exactly what Child Health Plus covers for dental, who qualifies in 2026, what it costs, and how to enroll in Queens today.
KEY TAKEAWAYS
- Child Health Plus covers children up to 400% of the Federal Poverty Level: For a family of four, that is approximately $124,800 per year a range that covers many middle-income Queens families who cannot afford commercial dental insurance.
- No deductible, no copayments: According to NY State of Health’s official Child Health Plus documentation, the program has no annual deductible and no copayments for any covered service, including dental.
- Monthly premiums range from $0 to $60 per child: Families with lower incomes pay nothing. Premiums are capped at three children per family, regardless of how many children are enrolled.
- Dental benefits are comprehensive: Covered services include preventive checkups, cleanings, X-rays, fluoride varnish, fillings, crowns, extractions, and orthodontics when medically necessary.
- Enrollment is open year-round: Unlike commercial insurance with fixed open enrollment windows, Child Health Plus accepts applications every day of the year through NY State of Health.
Medical disclaimer: This article provides general information about Child Health Plus in New York State. Eligibility rules, premiums, and covered benefits may change. Always confirm current details directly with NY State of Health or your Child Health Plus plan before making healthcare decisions.
What Is Child Health Plus and How Is It Different from Medicaid?
Child Health Plus (CHP) is New York State’s implementation of the federal Children’s Health Insurance Program (CHIP).
It is a state-sponsored health insurance plan specifically designed for children under age 19 whose families earn too much to qualify for Medicaid but cannot afford or access private commercial insurance.
The most important distinction for Queens parents to understand is the income threshold.
New York Medicaid covers children whose household income falls at or below approximately 154% of the Federal Poverty Level (FPL), about $48,000 per year for a family of four in 2026.
Child Health Plus picks up where Medicaid stops and extends coverage all the way to 400% FPL, approximately $124,800 per year for a family of four.
This wide income band means Child Health Plus is relevant to a much larger slice of Queens families than most parents realize.
| Program | Who It Covers | Income Range (Family of 4) | Monthly Premium | Deductible | Copays |
|---|---|---|---|---|---|
| Medicaid | Children under 19 | Up to ~$48,000/year (154% FPL) | $0 | $0 | $0 |
| Child Health Plus | Children under 19 not eligible for Medicaid | ~$48,000–$124,800/year (154%–400% FPL) | $0–$60/child/month | $0 | $0 |
| Commercial dental insurance | Anyone with coverage through an employer or the marketplace | No income limit | Varies widely; typically $15–$50/child/month | Typically $50–$100/year | Typically $10–$30 per visit |
A key feature that distinguishes Child Health Plus from commercial insurance is the absence of both deductibles and copayments.
There is no amount that families must pay before coverage kicks in, and no charge per dental visit or procedure.
For an enrolled child, the dentist visit costs nothing beyond the monthly premium, which itself may be $0 for lower-income families within the eligible range.
Understanding the full range of public coverage options available in New York is essential for Queens families navigating their options.
Our guide to Medicaid dental coverage for kids in New York covers the Medicaid side of this picture in detail.
What Dental Services Does Child Health Plus Cover?
Child Health Plus covers dental care as part of its comprehensive Essential Health Benefits package.
According to Healthfirst, one of the leading Child Health Plus insurers in Queens and NYC, covered dental services include all of the following with no deductible and no copayments:
| Service Category | Covered Services | Frequency / Notes |
|---|---|---|
| Preventive dental care | Routine exams, professional cleanings, dental X-rays, fluoride varnish treatments | Typically 2 per year; no copay required |
| Restorative care | Fillings (composite and amalgam), stainless steel crowns, white crowns | Covered when medically necessary; no copay |
| Oral surgery | Simple tooth extractions, surgical extractions | Covered; no copay |
| Preventive treatments | Dental sealants, Silver Diamine Fluoride (SDF) | Sealants covered for eligible teeth; SDF covered for all ages since Jan 2025 |
| Emergency dental care | Pain relief, infection treatment, and emergency extractions | Covered; no copay |
| Orthodontics | Braces and related orthodontic treatment | Covered when medically necessary; must be provided by an enrolled orthodontist |
The orthodontic coverage distinction is worth noting for parents of older children: Child Health Plus covers braces when medically necessary, meaning when there is a documented clinical need related to bite function, jaw development, or dental health, not cosmetic preference.
An orthodontist who participates in Child Health Plus can document medical necessity and submit for coverage.
Many Queens families with children in mixed or early permanent dentition qualify for this benefit without realizing it.
No referral from a primary care doctor is required to see a dentist under Child Health Plus.
You can contact a participating dental office directly to schedule an appointment.
The dentist must be enrolled in your specific Child Health Plus managed care plan, with the same in-network requirement that applies to Medicaid Managed Care.
Our Queens dental care guide lists community health centers and FQHCs that accept Child Health Plus across all Queens neighborhoods.
2026 Income Eligibility and Monthly Premiums
Child Health Plus eligibility and premiums are based on household income relative to the Federal Poverty Level (FPL).
The 2026 figures are based on 2025 FPL guidelines, as confirmed by the NY State of Health Child Health Plus At a Glance documentation.
Children qualify for Child Health Plus if they are under age 19, live in New York State, and are not currently enrolled in or eligible for Medicaid.
Unlike Medicaid, Child Health Plus is available regardless of immigration status.
Undocumented children are eligible for the full Child Health Plus benefit package.
Premium structure for 2026:
| Household Income (Relative to FPL) | Monthly Premium per Child | Notes |
|---|---|---|
| Up to 160% FPL (~$49,720/year for family of 3; ~$60,240 for family of 4) | $0 | No premium charged |
| 160%–222% FPL | $15/child/month | Capped at 3 children ($45/month maximum for family) |
| 222%–322% FPL | $30/child/month | Capped at 3 children ($90/month maximum for family) |
| 322%–400% FPL | $45–$60/child/month | Varies by plan; capped at 3 children |
| Above 400% FPL | Full premium (varies by plan) | May still enroll, but at market rate; marketplace plans likely more competitive |
According to Community Health Advocates, the premium is capped at three children per family, regardless of how many children are enrolled, meaning a family with five children enrolled in Child Health Plus at the $15 tier pays a maximum of $45 per month for all five children combined.
To estimate your specific premium based on household income and family size, use the NY State of Health cost estimator tool at nystateofhealth.ny.gov or call 1-855-355-5777 Monday through Friday, 8 am–8 pm, or Saturday, 9 am–1 pm.
Which Child Health Plus Plans Are Available in Queens?
Child Health Plus operates through managed care plans, private health insurers contracted by New York State to administer the benefit package.
In Queens County, several plans offer Child Health Plus coverage.
The plans currently operating in Queens include major insurers such as Healthfirst, Fidelis Care, MetroPlus, and WellCare, among others.
Each plan has its own network of participating dentists.
The dental coverage benefit package is the same across all Child Health Plus plans (no deductible, no copays, same covered services).
The difference is which specific dentists and dental offices participate in each plan’s network.
How to choose the right plan for your child:
- Use the NY State of Health Plans by County tool at nystateofhealth.ny.gov to see all plans available in Queens County
- If your child already has a preferred dentist, check which Child Health Plus plans that dentist participates in before selecting a plan
- If you do not yet have a dentist, select the plan that includes the most convenient participating pediatric dental offices in your neighborhood
- Use the NYS Provider & Health Plan Look-Up tool at pndslookup.health.ny.gov to search for dentists by plan, specialty, and zip code
Healthfirst Child Health Plus contracts with DentaQuest to administer dental benefits for its members in Queens.
DentaQuest has a broad network of participating providers, including community health centers and private practices throughout the borough.
Fidelis Care, with over 2.4 million members statewide, is another high-enrollment option with strong provider networks in southeastern Queens.
Once enrolled, call your plan directly if you have trouble finding a participating dentist.
Plans are required by state law to ensure adequate network access.
If the plan cannot locate an in-network provider within a reasonable distance, it must arrange out-of-network coverage at the in-network rate.
How to Enroll in Child Health Plus in Queens
Enrollment in Child Health Plus is open every day of the year; there is no restricted open enrollment period.
You can apply and start coverage at any time, with coverage typically beginning the first day of the month following your application approval.
Three ways to enroll:
- Online: Visit nystateofhealth.ny.gov and complete the application. The system automatically determines whether your child qualifies for Medicaid, Child Health Plus, or another program based on the income and household information you provide.
- By phone: Call NY State of Health at 1-855-355-5777 (Monday–Friday 8 am–8 pm, Saturday 9 am–1 pm). A customer service representative can complete the application with you over the phone in any language.
- In person with an enrollment assistor: Certified enrollment assistors are available in Queens neighborhoods at community organizations, health centers, and libraries. Find one near you using the “Find Local Help” tool at nystateofhealth.ny.gov.
Documents you will typically need:
- Proof of the child’s age (birth certificate or passport)
- Proof of New York State residency (utility bill, school records, or lease)
- Proof of household income (pay stubs, tax return, or employer letter)
- Social Security numbers for household members (where applicable)
Child Health Plus is available regardless of immigration status.
You do not need to provide immigration documentation to enroll a child.
Enrollment assistors are bound by confidentiality; they cannot report immigration information to government authorities.
After enrollment, your child’s plan will send an insurance card.
You can begin scheduling dental appointments as soon as you receive your plan confirmation and member ID number. You do not need to wait for the physical card to arrive.
Present your member ID number to the dental office when scheduling.
Our guide to your child’s first dental visit covers what to expect at that appointment and what questions to ask, useful reading whether you are enrolling a toddler for the first time or scheduling a catch-up visit for an older child.
Renewing Child Health Plus Coverage
Child Health Plus coverage must be renewed annually.
NY State of Health will send a renewal notice by mail, email, or phone approximately 60–90 days before your child’s coverage renewal date.
It is critical to respond to this notice promptly; failure to renew results in coverage termination, which means dental appointments scheduled after the lapse date will not be covered.
Common renewal mistakes Queens families make:
- Outdated contact information renewal notices sent to an old address or email are missed entirely. Log in to your NY State of Health account and confirm your phone number, email, and mailing address are current.
- Ignoring the notice because nothing seems to have changed, even if your income and household size are identical to last year, you must still complete the renewal to confirm continued eligibility.
- Assuming the plan auto-renews, Child Health Plus does not automatically renew without action on the family’s part.
- Missing the deadline if coverage lapses due to a missed renewal, you can re-enroll at any time (enrollment is open year-round), but there may be a gap in coverage.
The upcoming federal Medicaid changes introducing six-month eligibility redeterminations scheduled to take effect by December 31, 2026, will primarily affect Medicaid enrollees, not Child Health Plus directly.
However, families near the Medicaid income threshold may find themselves shifting between Medicaid and Child Health Plus as income fluctuates.
In those cases, NY State of Health automatically reassesses eligibility and transitions children to the appropriate program without requiring a new application.
Child Health Plus vs. Commercial Dental Insurance: Which Is Better for Your Child?
For families who qualify for Child Health Plus at a $0 or low premium, the program is almost always the better choice over commercial dental insurance.
The comparison below assumes a family at the 200% FPL tier paying $15 per child per month:
| Feature | Child Health Plus | Typical Commercial Dental Plan |
|---|---|---|
| Monthly premium (per child) | $0–$60 (income-based) | $15–$50+ |
| Annual deductible | $0 | $50–$100 |
| Copay per dental visit | $0 | $0–$30 |
| Annual benefit maximum | No cap on covered services | Typically $1,000–$2,000 |
| Orthodontics | Covered when medically necessary | Lifetime max of $1,000–$2,000 (if included) |
| Enrollment window | Open year-round | Annual open enrollment period |
| Coverage for undocumented children | Yes | No |
The most significant advantage of Child Health Plus over commercial dental plans is the absence of an annual benefit maximum.
Commercial dental plans typically cap coverage at $1,000–$2,000 per year, meaning a child who needs multiple fillings, a crown, and a pulpotomy in a single year can exhaust their commercial plan coverage entirely and face hundreds or thousands in out-of-pocket costs.
Child Health Plus has no such cap: all covered services are provided regardless of the total cost in a given year.
For Queens families currently paying out of pocket for dental care or enrolled in a costly commercial plan, running a Child Health Plus eligibility check takes 10 minutes and could eliminate dental bills entirely.
Understanding the full cost of pediatric dental services makes it clear just how significant this benefit is for families who qualify.
The Bottom Line on Child Health Plus Dental Coverage
Child Health Plus is New York’s most underutilized children’s dental benefit.
With income eligibility extending to 400% of the Federal Poverty Level, approximately $124,800 per year for a family of four, it covers a wide range of Queens families who assume public coverage is not for them.
The benefit is comprehensive: no deductible, no copays, full coverage for cleanings, fillings, crowns, and medically necessary orthodontics.
Monthly premiums range from $0 for lower-income families to a maximum of $60 per child, capped at three children per family.
If your child is uninsured, underinsured, or if you are paying significant out-of-pocket dental costs, check eligibility today at nystateofhealth.ny.gov or call 1-855-355-5777.
Frequently Asked Questions About Child Health Plus Dental Coverage
Does Child Health Plus cover braces for children?
Yes. Child Health Plus covers orthodontic treatment, including braces, when it is medically necessary.
Medical necessity means there is a clinical reason related to bite function, jaw development, or dental health, not simply cosmetic preference.
An orthodontist enrolled in your Child Health Plus plan can evaluate your child, document medical necessity, and submit for coverage.
There is no copayment and no lifetime cap on medically necessary orthodontic benefits under Child Health Plus.
Can my child have both Child Health Plus and private dental insurance?
Children cannot have duplicate public coverage, but they can have other coverage alongside Child Health Plus in some circumstances.
If your employer offers dental insurance and Child Health Plus also covers your child, Child Health Plus typically coordinates as secondary coverage.
In practice, most families in the Child Health Plus income range use it as their primary or only coverage. Confirm coordination rules with your specific plan.
Is Child Health Plus available for children of undocumented immigrants?
Yes. New York’s Child Health Plus program is available to children regardless of immigration status.
Children do not need a Social Security number to enroll, and enrollment assistors are bound by confidentiality.
Enrollment information cannot be shared with immigration authorities.
This is one of the key differences between Child Health Plus and federal Medicaid, which has more restrictive immigration requirements for some beneficiary categories.
What happens when my child turns 19?
Child Health Plus coverage ends at age 19.
Depending on household income at that time, the young adult may qualify for New York Medicaid (up to 138% FPL), the Essential Plan (138%–200% FPL), or marketplace Qualified Health Plans with or without premium tax credits.
NY State of Health will send transition notices as your child approaches age 19 and will assess eligibility for other programs automatically.
How is Child Health Plus different from the Essential Plan?
Child Health Plus covers children under 19.
The Essential Plan covers adults ages 19–64 who earn too much for Medicaid (138%–200% FPL).
The two programs are distinct: a child in a household may be on Child Health Plus while a parent in the same household is on the Essential Plan. Both programs are administered through NY State of Health with year-round enrollment.
Sources
- NY State of Health Child Health Plus Information (Official Program Page)
- NY State of Health Child Health Plus At a Glance Card 2026
- Healthfirst Child Health Plus Plan: Dental and Benefits Overview (Updated January 2026)
- Community Health Advocates Child Health Plus Premium Chart and Enrollment Guide
- NY State of Health 2026 Open Enrollment Press Release (November 2025)
- CheckMedicaid New York Medicaid Income Limits 2026 (Updated March 2026)
- HealthInsurance.org New York Dental Insurance 2026 Guide
Mary – Queens Pediatric Dental Resource Manager. I’m a dental health researcher and parent advocate based in Queens, NY. After struggling to find reliable pediatric dental information during my own child’s dental emergency, I created this resource to help other Queens families navigate their children’s oral health needs.
I curate evidence-based information from leading pediatric dental organizations, peer-reviewed research, and trusted dental health experts. While I’m not a dentist, I’m committed to providing accurate, practical guidance that helps parents make informed decisions.
All content is thoroughly researched and includes proper medical disclaimers directing families to consult qualified pediatric dentists for their children’s specific needs.