Family Health Insurance : Understanding Family Health Plus

The Family Health Plus insurance plan is a program offered by the State of New York to help families who do not have family health insurance. This program is for adults without children who are between 19 and 64 as well as parents without health coverage and those who do not qualify for Medicaid.


Adults who are between 19 and 64 may join the Family Health Plus plan if they are not covered under any family health insurance plan or other health insurance program. They must also meet certain income guidelines which are defined by the State of New York and be a New York State resident.


Certain medical services do require a co-payment, which is paid directly to the provider although providers can not refuse to provide services if the individual can not cover the co-pay cost. If unable to pay the co-payment at the time of services, individuals will be sent a bill for the co-pay amount.

Coverage Details

Coverage includes routine visits to doctors for sickness, minor injuries and checkups, visits to specialists, lab work, x-rays, diagnostic tests, speech, hearing and vision services, outpatient surgery, emergency transportation and emergency treatments, inpatient hospital costs for surgical, medical, mental health and substance and alcohol abuse. This coverage also covers medical equipment, prosthetics, radiation, chemotherapy, hemodialysis, dental care, family planning, physical and occupational therapy, outpatient treatment for substance and alcohol abuse, outpatient treatment for mental health and home health care. Prescription drug coverage is provided through Medicaid Fee for Service.

Choose Your Own Doctor

There are a list of primary care physicians that the insured can choose from.
They become the primary doctor who will care for and arrange all health care needs.

Emergency Treatment

Family Health Plus does cover emergency treatment although individuals must notify their primary care physician as soon as possible. The doctor will instruct the patient at home either to come into the office for treatment or to go the closest emergency room for treatment.

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