MedicaidCoverageMedium impact
Medicaid and CHPlus Continuous Eligibility for Children up to Age Six
EmblemHealth·NY · Pediatrics, Family Medicine, General Practice·Provider News
Effective date
Jan 1, 2025
We identified it
Jun 20, 2026
Summary
Medicaid and CHPlus now provide continuous eligibility for children from birth through age six, effective January 1, 2025, expanding from the previous 12-month continuous eligibility period. This ensures uninterrupted healthcare coverage for young children but does not apply to full premium CHPlus members.
Action Required
Immediately: Update patient eligibility verification procedures to account for continuous Medicaid/CHPlus coverage through age six. Front desk staff should note that children under six with Medicaid/CHPlus maintain continuous eligibility and do not require frequent re-verification. Billing team should be aware that coverage interruptions are less likely for this age group, reducing claim denials due to eligibility lapses.