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This one application can be used to apply for Children's Medicaid, Child Health Plus, Family Health Plus, Medicaid, Prenatal Care Assistance Program (PCAP), and Women, Infants and Children (WIC) nutritional programs. Based upon the information you provide, you will be told which program you and/or your child(ren) are eligible for. The Access NY Health Care application is available as an Adobe Acrobat Portable Document Format file. Do you need help working with PDF files? Help is available with completing the application, but if you would like to submit it directly to an insurer, please read these directions first. You can get a hardcopy of this application by calling 1-800-698-4543 or by emailing chplus@health.state.ny.us. If you are hearing impaired, call the TTY number, 1-877-898-5849. English Instructions (PDF, 601KB, 4pg.)
Application (PDF, 98KB, 6pg.)
Additional Application Information (PDF, 57KB, 2pg.)
Documentation Checklist for Health Insurance (PDF, 71KB, 4pg.)
Fact Sheet (PDF, 58KB, 1pg.)
All of the Access NY Health Care application files in one (PDF, 847KB, 17pg.) Español Instrucciones (PDF, 2.07MB, 4pg.)
Applicación (PDF, 225KB, 6pg.)
Información Adicional para la Applicación (PDF, 76KB, 2pg.)
Lista de comprobación de la documentación para el seguro médico (PDF, 154KB, 4pg.)
Hoja de Hechos (PDF, 61KB, 1pg.)
Todos los archivos de Access NY Health arriba listados en un solo archivo (PDF, 2.53MB, 17pg.)
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