New York State Essential Plan: Resources and Information

New York State residents who meet certain eligibility standards may enroll in an Essential Plan, a program for low-income New Yorkers enrolling in coverage through NY State of Health, the state’s official health plan marketplace.

 

Eligibility requirements — individuals must be:

  • New York State residents
  • Able to meet the Essential Plan income requirements
  • Lawfully present in the U.S.
  • 19-64 years old
  • Not eligible for Medicaid or Child Health Plus
  • Not eligible for employer and other coverage

 

Covered Services:

  • Free preventive care
  • Inpatient care
  • Outpatient services
  • Maternity and newborn care
  • Emergency services
  • Lab and imaging
  • Prescription drugs
  • Rehabilitative and habilitative services
  • Mental health and substance use disorder services
  • Wellness and chronic disease management services

 

Is there a specific enrollment period?

Enrollment for the Essential Plan is open all year long.

 

How much does an Essential Plan cost?

Eligible consumers will pay either a $20 monthly premium or $0, depending on their income. Some plans include additional benefits such as adult dental and vision coverage for additional premium.

 

For more information about the Essential Plan:

NY State of Health – Essential Plan at a Glance

NY State of Health – Essential Plan Fact Sheet

Map detailing which carriers offer Essential Plans in which NY counties

 

Source: https://nystateofhealth.ny.gov/