NY State Essential Plan Income Eligibility 2024 pdf free

No Medicaid? No problem! check your Essential Plan income eligibility 2024 here.

If you do not qualify for Medicaid, this is another good opportunity for you. Are you a working adult with low income in New York State? If yes, you may qualify for the 2024 NY State of Health’s Essential Plan. Essential plan offers quality health insurance benefits to working adults with lower incomes.

To qualify for this health insurance, there are several eligibility requirements. These include; age, where you live, income level, citizenship, immigration status etc.

Benefits of NY State of Health’s Essential Plan

NY State of Health’s Essential Plan offers comprehensive benefits with no monthly premium and very low cost sharing

  • It has no deductible, so the plan starts paying for your health care right away.
  • It covers comprehensive benefits, including dental and vision, inpatient and outpatient hospital care, prescription drugs and more.
  • It also covers free preventive care like routine doctor exams and screenings to keep you healthy.

NY State Essential Plan Eligibility 2024

  • You must be an adult who is between 19 – 64 years of age. However, if you are under 19 years old, you are eligible for Child Health Plus, instead of the Essential Plan.
  • You must be a New York State resident.
  • You meet income eligibility requirements. (Examples: single adults earning up to $25,520; adults in family of four earning up to $52,400)
  • You must be a U.S. citizens or meet immigration status requirements.
  • Meet certain income eligibility requirements tied to household size.

NY State Essential Plan Immigrant Eligibility

You may qualify if you are;

  1. a U.S. citizen,
  2. legal permanent resident,
  3. lawfully present resident,
  4. a valid, nonimmigrant status (for example, a visiting student with a valid visa).

NY State Essential Plan Income Eligibility 2024 pdf

Income limits are related to your family size. The following chart explains how your income and family size is structured.

* (150% to 200% FPL)
** Add $10,280 for each additional member of your family

NY State Essential Plan Coverage Cost

It depends on your income. You will either pay no premium or $20/month. You will not have to meet an annual deductible. That means the Essential Plan will start paying for services, like doctor visits, right away.

Depending on your income, you may have to pay a small fee when you get care, like going to the doctor or filling a prescription.

NY State Essential Plan Coverage

All plans will cover the same 10 benefits, including hospital care, prescription drugs, and doctor visits. You can get free
preventive care, like annual well visits and health screenings. You can also get free dental and vision care or pay for these benefits, depending on your income.

How to apply

The Essential Plan is available  throughout the year.

  • You can apply online, over the phone, or in-person. Assistance is available in many languages.
  • Visit the NY State of Health, or call 855-355-5777 or 311.
  • Find an in-person enroller near you.