Essential Plan, also known as “EP” is affordable, comprehensive health insurance for low and moderate-income adults living in New York who are not eligible for Medicaid. EP is provided through managed care plans and offers essential health benefits. See the questions below to determine if you qualify for EP and if it is the best option for you.
Who qualifies for Essential Plan?
You may qualify for Essential Plan if:
- You are a NYS resident
- Your monthly income in 2020 is below $2,127 for a single person or $4,367 for a family of four
- You are a US/Naturalized Citizen or an immigrant present with the knowledge and consent of the US immigration service
- You are between 19 and 64 years old
- You are not eligible for Medicaid or any other health plan
How much does Essential Plan cost?
Essential Plan has a monthly premium of $0 or $20 depending on your income. The Essential Plan has no deductible, and you can begin going to a doctor right away. You may pay a small fee called a co-payment for certain covered services.
What services will Essential Plan cover?
EP will cover essential health benefits (EHBs), including:
- Free preventive care
- Inpatient care
- Outpatient services
- Maternity and Newborn Care
- Mental Health and Substance Abuse Disorders
- Emergency services
- Lab and imaging
- Prescription drugs
- Rehabilitative and habilitative services
- Wellness and chronic disease management services
How do I enroll in Essential Plan?
You can enroll in person, online, or over the phone. If you need assistance enrolling into Essential Plan or want more information, please contact CHA at 888-614-5400.