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Child Health Plus

We’ve served BlueCross BlueShield of Western New York members with Child Health Plus benefits since 1936. Your health is our purpose. We can help your child get and stay healthy.

Your child can get well-checkups, immunizations, vision care, dental care and more with BlueCross BlueShield of Western New York.

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
  • Adult dental care (ages 21 and over)
  • Behavioral health and substance abuse disorder services
  • Certain doctors for children with special health care needs

We’ll also pay for the lab work and medicine related to this service:

  • Adult vision care (age 21 and over)

Frequently asked questions

How do I get help after my child’s primary care provider’s (PCP’s) office closes?

Unless it’s a life-threatening emergency, do not go to the emergency room (ER). Instead, call our 24/7 NurseLine at 1-866-231-0847 (TTY 711) to talk to a nurse any time, day or night. Our nurses can answer questions about your health or help you find an urgent care facility near you.

Can I call my child’s specialist’s office directly to set up an appointment?

Your PCP will refer your child to a specialist. If your child needs specialist services that your child can’t get from a BlueCross BlueShield plan doctor, we’ll work with your child’s PCP to refer him or her to an out-of-plan specialist. Your child’s PCP must call BlueCross BlueShield at 1-866-231-0847 (TTY 711) to request approval for an out-of-plan referral.

My child’s plan has dental benefits. How do we choose a dentist?

If you need to find a dentist for your child, please call Liberty Dental toll free at 1-833-276-0846 (TTY 1-877-855-8039) Monday through Friday from 8 a.m. to 8 p.m. Eastern time. You can also call Member Services at 1-866-231-0847 (TTY 711). When your child visits the dentist, you should show your child’s plan ID card.

How do I get a copy of the BlueCross BlueShield provider directory?

Please call Member Services at 1-866-231-0847 (TTY 711) and request one. You can also view our provider directory online.

How do we see a doctor who is not a BlueCross BlueShield plan doctor?

Please call Member Services at 1-866-231-0847 (TTY 711) Monday through Friday from 8:30 a.m. to 6 p.m. with questions.

Extra Benefits

New Baby, New LifeSM BlueCross BlueShield of Western New York Healthy Rewards Incentive
  • $25 incentive for prenatal visit in the first trimester or within 42 days of enrollment into BlueCross BlueShield
  • $25 incentive for attending postpartum visit 21 to 56 days after delivery
  • $25 incentive for attending at least six prenatal care visits
  • $25 incentive for baby’s 2-week checkup within the first two weeks of life
  • $25 incentive for attending at least six well-child checkups by 15 months of age

Different eligibility rules apply to each benefit. Look in your member handbook or call us at 1-866-231-0847 (TTY 711) to learn more.

Enroll in BlueCross BlueShield

Your pharmacy benefits

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

Visit the pharmacy page to find a pharmacy near you and check if your medicine is on the Preferred Drug List (PDL).

Go to Pharmacy page

BlueCross BlueShield of Western New York 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 1-866-231-0847 (TTY 711) Monday – Friday from 8:30 a.m. – 6 p.m. Eastern time.

Enroll in BlueCross BlueShield

Your member handbook is your go-to guide for health services. It tells you how you can get the most from BlueCross BlueShield of Western New York. You’ll find answers to these items:

  • Your benefits
  • Your rights and responsibilities.
  • How to get helpt 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 Handbooks
Notice of Privacy Practices

New Baby, New Life℠ BlueCross BlueShield Healthy Rewards Incentives

  • Earn 250 points ($25) in rewards for attending a prenatal visit in the first trimester or within 42 days of enrollment into BlueCross BlueShield.
  • Earn 250 points ($25) in rewards for attending at least six prenatal care visits.
  • Earn 250 points ($25) in rewards for attending postpartum visit 21 to 56 days after delivery.
  • Earn 250 points ($25) in rewards for baby’s checkup by 2 weeks of age.
  • Earn 250 points ($25) in rewards for attending at least six well-child checkups by 15 months of age.

For more information, check online at www.bcbswny.com/healthyrewards or call 1-800-749-9036.

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