Child Health Plus

With Highmark's CHPlus plan, your child will have access to a wide range of services including dental and vision care and prescription drug coverage.

New to Highmark Child Health Plus?

As a new member, we know you have questions. We also know you’re short on time! Learn the basics about your health plan on the New Member Welcome page.

What you get with CHPlus

Your child can get well-checkups, immunizations, vision care, dental care and more with Highmark.

 

Get benefits like:

 

 Prescription drug coverage and over-the-counter medicines

 

 Specialist care, X-rays and lab tests

 

 Emergency hospital visits and inpatient hospital, medical and surgical care

 

 

When you need a referral

 

For some services, you’ll need a referral from your primary care provider (PCP) before getting care. You’ll need to see your PCP before:

 

 Going to a hospital for nonemergency care

 

 Getting medicine your PCP can’t give you

 

 

Get these services from us without a referral

 

For most services, you’ll go to your PCP or another doctor in your plan. We’ll pay for some services you get from a doctor who isn’t in your plan, including:

 

 Family planning

 

 Pregnancy services

 

 Emergency services

 

 School-based health center services

 

 Behavioral health and substance abuse disorder services

 

 Certain doctors for children with special health care needs

 

You should not be charged for your child’s personal protective equipment.

 

You do not have to pay doctors in your child’s plan network for personal protective equipment, like masks, gloves, or gowns required during visits. If you have paid these charges, you should contact the doctor for a refund. If you would like to submit a complaint to us about charges for any personal protective equipment from a doctor in your child’s network, please contact Member Services at 866-231-0847 (TTY 711).

Who’s eligible?

Highmark offers the New York State-sponsored Child Health Plus program. We can help you get the most out of your Child Health Plus benefits so you can help your family get and stay healthy.

 

Your child may be eligible for Child Health Plus if your child:

 

 Is under the age of 19

 

 Is not eligible for Medicaid

 

 Has little or no other health insurance coverage

 

 Lives in one of the following counties: Allegany, Cattaraugus, Chautauqua, Erie, Genesee, Niagara, Orleans, or Wyoming

 

 A child does not have to be a U.S. citizen or legal resident to qualify for Child Health Plus. Participation in this program will not affect any future immigration status.

 

To find out more about eligibility, visit the New York Child Health Plus website.

Already a member and have questions?

Please call Member Services at 866-231-0847 (TTY 711)

Monday – Friday from 8:30 a.m. – 6 p.m. Eastern time.

 

Enroll in Highmark 

Extra benefits

Get what you need to live your healthiest life. As a Highmark member, you get extra benefits, called value-added benefits, like:

 

 Free diapers after completing six prenatal visits, or after your baby completes a newborn checkup

 

 A car seat or portable crib for pregnant members who complete six prenatal visits

 

 Free dental hygiene kits for members ages 13-18 years

 

 A stroller for new moms who complete a postpartum checkup within 7-82 days

 

 $20 Uber gift card for going to healthcare visits and other places in the community


Limitations and restrictions apply. Benefits may change.

 

You can redeem some benefits online through your secure account. Discover the extra benefits you’re eligible for on the Benefit Reward Hub or call Member Services at 866-231-0847 (TTY 711) Monday through Friday, 8:30 a.m. to 6 p.m. Eastern time.

 

Log in to your secure account to get started today!

 

 

Earn rewards for healthy activities

Healthy Rewards is a no-cost, optional program for eligible members enrolled in our health plan. The program encourages members to seek the care they need to improve their health and create a healthy lifestyle.

 

To understand extra benefit eligibility and start earning rewards, log into your Benefit Reward Hub or call Member Services at 866-231-0847 (TTY 711) – available Monday through Friday, 8:30 a.m. to 6 p.m. Eastern time.

 

 

Log into Benefit Reward Hub 

Member handbook

 

Your go-to guide for health services

 

Your member handbook tells you how you can get the most from Highmark. You’ll find answers to these items:

 

 Your benefits

 

 Your rights and responsibilities

 

 How to get help after your doctor's office closes

 

 How to choose a primary care provider

 

 Renewing your coverage

 

 How to reach Member Services if you have a question

Member resources

CHPlus Pharmacy benefits

Your pharmacy benefits include a wide range of prescription and over-the-counter (OTC) drugs. We work with CarelonRx to provide these benefits. There are no copays for covered drugs.

Specialty pharmacy: extra care to manage your condition

Specialty pharmacy: extra care to manage your condition 

A specialty pharmacy does more than just fill prescriptions. These pharmacies serve members with complex or chronic conditions. Specialty medications are used to treat these conditions and often require special storage or extra support. Specialty pharmacies have highly trained pharmacists and nurses to provide personal care and guidance to help you manage your condition. 

 

If you have a specialty condition, you have the option to use BioPlus Specialty Pharmacy for your medications. These medications are delivered to your home or shipped to a local pharmacy for pickup. 

 

 Specialty Drug List - English

 

 Specialty Drug List - Spanish

 

With BioPlus specialty pharmacy, you get: 

Free shipping with confidential, on-time delivery 

 

Order your medicine online at any time. You can choose to have your prescription mailed to you or shipped to a school, business, doctor’s office, or retail pharmacy where you can pick it up. And, you can track your order until it arrives. 

 

Member specialty pharmacy resources

 

Log in to your account to manage your specialty prescriptions. You can:

 

 Order a refill

 

 Check your order status

 

 View your prescriptions

 

 Lives in one of the following counties: Allegany, Cattaraugus, Chautauqua, Erie, Genesee, Niagara, Orleans, or Wyoming

Care Team support

Call Specialty Pharmacy Member Services at 833-549-2115 (TTY 711) anytime day or night to speak with your Care Team.

 

 

Log Into Benefit Reward Hub 

 

LiveHealth Online

LiveHealth Online allows you to visit a doctor through live video chat on your computer, tablet or smartphone. It’s an easy way to get care for you or your family at any time, day or night, without leaving your home.

 

As a Highmark member, you can use LiveHealth Online at no cost to you. Sign up today so you can:

 

 See a doctor in minutes: Use LiveHealth Online to get help when you have a common health problem like a cold, the flu, fever, pink eye, sore throat, sinus infection and more

 

 Get prescriptions sent to your pharmacy if needed*

 

 Make an appointment with a Spanish speaking doctor: Speak to a doctor in your own language seven days a week through Cuidado Médico on LiveHealth Online

 

 Lives in one of the following counties: Allegany, Cattaraugus, Chautauqua, Erie, Genesee, Niagara, Orleans, or Wyoming

 

It’s easy to get started. Sign up for free on the LiveHealth Online website or download the app:

*Prescription availability is defined by physician judgment.

 

LiveHealth Online is the trade name of Health Management Corporation, a separate company providing telehealth services on behalf of Highmark.

Frequently asked questions