The Essential Plan is a program for eligible New Yorkers enrolling in coverage through the NY State of Health. Eligible consumers will pay either $20 monthly premium or nothing, depending on income. Your income will determine which plan you are eligible for. This proposal also builds on the Essential Plan, allowing individuals with incomes previously just above the eligibility level to choose to purchase the Essential Plan from the New York State of Health Marketplace. What is the Essential Plan? In the rest of the country, it’s insurance companies that stand to forfeit money if Trump follows through on his threat. Are a New York State resident. Coverage is offered to employees/retirees of NYS government, the State Legislature and the Unified Court System. How to Calculate: Add the total from these sources. The Essential Plan was first available through NY State of Health … If you have a driver's license or ID issued by NYS DMV. Costs vary between tiers depending on your eligibility: Monthly premium is $0 or $20; Office visits are $0, $15 for a PCP and $25 for … Questions and Answers on Grace Period and Coronavirus Special Enrollment Period - English. It costs much less than other ... nystateofhealth.ny.gov OR 1-855-355-5777 or TTY: 1-800-662-1220 OR Through free in-person ... NY State of Health complies with applicable Federal civil rights laws and state … Coverage could be as little as $0 per month. Essential Plan members are required to report their pregnancy and the NY State of Health will determine their eligibility for Medicaid at that time. Your eligibility for the 2021 plan year of New York State or federally-sponsored programs, financial assistance, or tax credits is determined by your household income and size compared to the Federal Poverty Level and other requirements. Many New Yorkers think they can't get health insurance because it costs too much, but with NY State of Health's new "Essential Plan" if you qualify, coverage could be as little as $20 a month. Additional information regarding the Essential Plan is available in these resources: This is the official informational website of NY State of Health The Official Health Plan Marketplace. Meet income eligibility requirements. Call us directly at 866-247-5678, and we will help you apply. All enrollees in the Essential Plan in 2015 were lawfully residing immigrants with income below 138 percent of FPL ($16,240 for a household of one and $33,465 for a household of four). All rights reserved. Does the waiver of cost-sharing apply to the Essential Plan, Child Health Plus, and Medicaid Managed Care Plans? The Essential Plan is a program for eligible New Yorkers enrolling in coverage through the NY State of Health. Preventive care and chronic disease management 2. Apply online, over the phone, or in-person. New York State of Health is a state … Plans must be submitted to unions and labor management committees within 150 days, and plans need to be finalized on April 1, 2021. ALBANY, N.Y. (November 14, 2019) - NY State of Health, the state's official health plan Marketplace, today announced that beginning November 16, … Call our help line … All rights reserved. Essential Plan Eligibility for families: Essential Plan 1 Essential Plan 2 Essential Plan 3 Essential Plan 4 Family of 2 $23,896 - $31,860 $21,983 - $23,895 $15,930 - $21,982 Below $15,930 Family of 3 $30,135 … Click on a county or borough shape on the map to view the certified plans for that area. In addition, the site will provide proposed State Plan … Fidelis Care offers four types of Essential Plans: Essential Plan 1, 2, 3, and 4. The Essential Plan is a public free- or low-premium plan for individuals with incomes … The Essential Plan is available at any time of year, but only if you enroll on the NY State of Health … The Essential Plan is a health insurance plan in New York for people who have limited income, but don’t qualify for Medicaid. ... NY State of Health, the Official Health Plan Marketplace (aka “the Exchange”) lets you compare plans and premium rates. The vast majority of the e… Free and confidential family planning services for adults and teens who qualify. Requested 2021 Rate Actions . To learn more about applying for health insurance, including Medicaid, Child Health Plus, Essential Plan, and Qualified Health Plans through NY State of Health, The Official Health Plan Marketplace, visit www.nystateofhealth.ny.gov or call 1-855-355-5777. Emergency Services and hospitalization 3. Haga clic en uno de los contornos de condado o distrito en el mapa para ver los planes certificados para esa área. You can also go to the NY State of Health’s website to view your choices, or call the NY State of Health customer service center at 1-855-355-5777. The amount you pay when you get services can include your copay, coinsurance, and deductible. ), This is the official informational website of NY State of Health The Official Health Plan Marketplace. Monday - Friday, 8 a.m. - 8 p.m.Saturday, 9 a.m. - 1 p.m. Individuals who enroll in Qualified Health Plans through NY State of Health or directly through insurers by August 15, 2020 will have a choice of coverage start date either August 1 or September 1, 2020. A plan that costs much less than other health plans, and offers the same essential benefits. This proposal would build on the Basic Health Plan option in New York, called the Essential Plan. Visit the NY State of Health, or call 855-355-5777 or 311. There are a total of 4 Essential Plan … New York State Medicaid State Plan What is the Medicaid State Plan? Individuals who are eligible for other NY State of Health programs - Medicaid, Essential Plan and Child Health Plus - can enroll year-round. Help is free. (Es posible que deba permitir que se abran ventanas emergentes en su explorador). Call us at 1-855-809-4073 or contact us here. The NYS Provider & Health Plan Look-Up includes information about the health care providers that participate with health plans offered through the NY State of Health Marketplace, including Qualified Health Plans, the Essential Plan, Child Health … Visit New York State of Health to select the right health insurance for your individual, family or small business needs. This … … The Essential Plan is a health insurance plan in New York for people who have limited income, but don’t qualify for Medicaid. The Essential Plan offers access to essential health benefits, such as: 1. Monday - Friday, 8 a.m. - 8 p.m.Saturday, 9 a.m. - 1 p.m. The Qualified Health Plan Map and Essential Plan Map provide information about health plans offered in each county. As of September 30, 2015 approximately 259,000 individuals were enrolled in the Essential Plan. In New York, state government would take most of the hit. A Medicaid State Plan is an official document that describes the nature and scope of a state's Medicaid program. It includes a new directive that all non-essential … Essential Plan Rate Setting Assumptions. There are four versions of this plan, and eligibility depends on income and other factors. This plan does not need to be submitted to a state agency for approval but must be retained on the premises of the business and must made available to the New York State Department of Health (DOH) or local health or safety authorities in the event of an inspection. As happens so often in health policy, New York has more to lose than almost any other state. Essential Plan 2020 The health care you need, at a price you can afford. There are a total of 4 Essential Plan options and each option is based on your household income level. Preventive care such as routine office visits and recommended screenings are free. (Essential Businesses must continue to comply with the guidance and directives for maintaining a clean and safe work environment issued by the Department of Health). Some local government agencies and school districts also elect to participate in NYSHIP. Essential Plan Expansion for Lower-Income New Yorkers. This number only includes the former Medicaid enrollees who transitioned to Essential Plan, as any new enrollment among those applying during open enrollment will not be effective until January 1, 2016. This plan does not need to be submitted to a state agency for approval but must be retained on the premises of the business and must made available to the New York State Department of Health (DOH) or local health or safety authorities in the event of an inspection. What is the plan? You can get help in many languages. Learn more about Essential Plan Private Insurance/Qualified Health Plans . The Affordable Care Act (ACA) provides states the option to establish a basic health program for: Individuals with incomes between 138-200% of the Federal Poverty Level (FPL) who are ineligible for Medicaid or Child Health Plus (CHP), and do not have access to affordable employer coverage; and Independent Health is pleased to have been approved by the State of New York to administer a new plan beginning January 1, 2016, named the Essential Plan. It’s available through the NY State of Health for those who don’t have affordable insurance through their employer. Fidelis Care Qualified Health Plan Products are standardized plans offered by Fidelis Care via NY State of Health, the Official Health Plan Marketplace.. Plans fall into various "metal" levels based on their design and the level of cost sharing required: Platinum, Gold, Silver, Bronze, and Catastrophic Coverage. The state of New York is one of the few states providing basic health plans under … The Essential Plan was created especially for people who make too much to qualify for Medicaid, but may not make enough to afford a qualified exchange plan. Travelers from states that are contiguous with New York are exempt from the travel advisory; however covered travelers must continue to fill out the Traveler Health Form.Essential workers will continue to be exempt as well. Essential Plan members don’t need referrals. New York State of Health: The Official Health Plan Marketplace. There are four different types of the Essential Plan, and costs for each plan are dependent on family size and income. are eligible for Child Health Plus, not for the Essential Plan. These rate decisions do not include the Essential Plan, available only through the New York State of Health, which will still have premiums of $20 or less for lower-income New Yorkers who qualify. (You may need to allow pop-ups in your browser. The Basic Health Program (BHP) provides New York the opportunity to offer many consumers a lower-cost health insurance option than is available through New York State of Health (NY State of Health) today. Essential Plan insurer on NY State of Health at their renewal starting in 2016. The Essential Plan covers all of the essential health benefits covered under the Qualified Health Plans offered on the Marketplace, including inpatient and outpatient care, physician services, diagnostic services and prescription drugs among others, with no annual deductible and low out-of-pocket costs. You can enroll in the Essential Plan any time of year. The same services covered by other plans: Doctor visits, including specialists; Tests ordered by your doctor; Prescription drugs; Inpatient and outpatient care at a hospital; How do I enroll? What does the Essential Plan cover? A health plan for New Yorkers. © 2013 NY State of Health. The Essential Plan provides quality health insurance to individuals who do not qualify for Medicaid. A representative will contact you shortly to help you enroll. In addition, the Essential Plan has no deductible, so the plan starts paying for your health care immediately. Enrollment in the plan depends on the plan’s contract renewal with Medicare. In addition, the Essential Plan has no deductible, so the plan starts paying for your health care immediately. Lawfully present New York State residents with incomes less than 250% FPL who … EmblemHealth EP 3, 4, and Plus plans offer adult vision and dental as well. Learn more about How to Pick a Plan; You can Find In-Person Help to enroll. Call our help line. (Examples: single adults earning up to $25,520; adults in family of four earning up to $52,400) Meet immigration status requirements. Company . Earlier today, Governor Andrew M. Cuomo announced he is signing the "New York State on PAUSE" executive order, a 10-point policy to assure uniform safety for everyone. If you are not sure, check with your employer. This chart is a general overview of eligibility for the … For questions about health plans and income eligibility, call Univera Healthcare at 1-888-576-6542. Essential Plan New York's Basic Health Program. … Some plans include additional benefits such as adult dental and vision coverage for additional premium. Assistance is available in many languages. And it’s the only place you can receive financial assistance … EmblemHealth's Essential Plan is a no-deductible HMO plan with a $0 or $20 monthly premium. I would check New York State Medicaid or Child Health Plus , because even though those are not what your plan is named, if you click the Learn More section, it says: Medicaid and Children's Health Insurance Program (CHIP) are programs that provide free or low-cost health care coverage based on your household size, income, and other factors, like age and disability . NY State of Health Announces Annual Renewal Begins Saturday 500,000 New York State Households Expected to Renew Their Health Plan for the 2020 Plan Year Consumers Must Enroll or Renew by December 15 for Coverage Effective January 1. This plan is available to anyone who has both Medical Assistance from the State and Medicare. Maternity and newborn care 4. The transition of WMS enrollees is complete. Please fill out the form … To learn more about applying for health insurance, including Medicaid, Child Health Plus, Essential Plan, and Qualified Health Plans through NY State of Health, The Official Health Plan Marketplace, visit www.nystateofhealth.ny… Essential Plan has demonstrated that individuals will enroll in health insurance if it is affordable and provides comprehensive benefits. This portion of the Department of Health's website will provide New York's Medicaid State Plan, presented in its entirety and in sections, which is updated no less frequently than quarterly. If you look for a plan on NY State of Health, you can choose between four levels of plans: Bronze, Silver, Gold, and Platinum. Learn more about private insurance/qualified health plans Family Planning Benefit Program. How much can I afford to pay for health care when I need services? Individuals may qualify if they are 19 to 64 years of age, a New York state resident, do not already have health insurance, and are not eligible for Medicaid. © 2013 NY State of Health. You receive free preventive care such as routine doctor visits to get and keep you healthy. Approved 2021 Rate Actions . Updated for 2021: The Essential Plan is a New York health insurance program for state residents that don't qualify for Medicaid or the Child Health Plus Program. We look forward to helping you! Plans are insured through UnitedHealthcare Insurance Company or one of its affiliated companies, a Medicare Advantage organization with a Medicare contract and a contract with the State Medicaid Program. Coverage could be as little as $0 per month. Everyone should come to the Marketplace to see what it can offer. The essential health plans are offered under the Affordable Care Act, which is more commonly referred to as Obama Care. These rate decisions do not include the Essential Plan, available only through the New York State of Health, which will still have premiums of $20 or less for lower-income New Yorkers who qualify. Jun 24, 2019 Many New Yorkers think they can't get health insurance because it costs too much, but with NY State of Health's new "Essential Plan" if you qualify, coverage could be as little as $20 a month. The state said there is no cost increase in 2020 for most products, including Medicaid, Child Health Plus, Essential Plan and most private insurance plans, known as Qualified Health Plans. Call Now to See if You May Qualify for the New York Essential Plan (888)215-4045 . Business owners should refer to the State… You may be eligible for the Essential Plan through Empire if you: Are between the … New York State of Health can be used by individuals, families and small businesses with 100 or fewer employees. 1.855.355.5777 TTY: 1.800.662.1220. Prescription drugsEssential Plan members are also eligible for Fidelis Care's Fitness Reimbursement Program, as well as our Mail Order Pharmacy Program. Ready to Enroll ? Visit nystateofhealth.ny.gov/. Download Cost-Sharing Reductions Available in NY State of Health ; All plans cover 10 "essential health benefits," like hospital and doctor visits, maternity and newborn care, and prescription drugs. If you have a driver's license or ID issued by NYS DMV. Eligibility is based on your income and the size of your household. This is the official informational website of NY State of Health The Official Health Plan Marketplace. Each state develops its own Plan, as required under Section 1902 of the Social Security Act (Act), which is then approved by the federal Department of Health & Human Services (DHHS). Apply online, over the phone, or in-person. Governor Andrew M. Cuomo has announced new guidelines allowing travelers to New York to “test out” of the mandatory 14-day quarantine. More than 830,000 New Yorkers were enrolled in the Essential Plan as of July 31, 2020. As Essential Plan (EP) enrollees have no liability for charges in excess of any applicable in-network cost sharing, it is the expectation of the Department of Health that insurers and hospitals will … New Yorkers with incomes above 138 percent of poverty had the ability to enroll in the Essential Plan during the 2016 NY State of Health open enrollment period which beganon November 1, 2015. Who would be eligible? State Health Benefits Plans provide health insurance through the New York State Health Insurance Program (NYSHIP). You can compare plans side-by-side. The Essential Plan was created especially for people who make too much to qualify for Medicaid, but may not make enough to afford a qualified exchange plan. A plan that costs much less than other health plans, and offers the same essential benefits. DFS INDIVIDUAL MARKET RATE ACTION . Insurance plans available on the NY State of Health Marketplace (financial help is available) and directly from insurance companies. It's your place to shop, compare and enroll in a low-cost quality plan that's right for you. The state would also have to fund the program between January and March, the last quarter of the current fiscal year. This is the official Website of NY State of Health The Official Health Plan Marketplace. The regulation applies to insurers, Article 43 corporations, HMOs, and student health plans with a certificate of authority pursuant to Insurance Law section 1124, providing comprehensive coverage for hospital, surgical or medical care. NY State of Health offers a choice of health plans across all Marketplace programs in every county of the state, with free in-person assistance available to help consumers determine … More than 830,000 New Yorkers were enrolled in the Essential Plan … Report is also available in Portable Document Format (PDF); Annual Report to the Governor and Legislature December 2015. NY State of Health: The Official Health Plan Marketplace It’s your place to shop, compare and enroll in a low-cost quality plan that’s right for you. It’s available through the NY State of Health for those who don’t have affordable insurance through their employer. Updated for 2021: The Essential Plan is a New York health insurance program for state residents that don't qualify for Medicaid or the Child Health Plus Program. The Essential Plan is available at any time of year, but only if you enroll on the NY State of Health Marketplace. How is New York State of Health different from other online marketplaces? Qualified Health Plan Products. The plans would apply to both the state and localities, including school districts. HOW TO APPLY You can enroll in the Essential Plan any time of year. Are four versions of this Plan is an Official Document that describes the nature and scope of a State Medicaid. Calculate: Add the total from these sources se abran ventanas emergentes su..., the last quarter of the country, it ’ s contract renewal Medicare... A representative will contact you shortly to help you enroll test out of. And dental as well as our Mail Order Pharmacy program income will determine which Plan you are eligible for a. Contact you shortly to help you enroll Plan Private Insurance/Qualified Health plans family Planning Benefit program offers access to Health. We will help you apply and Medicare New guidelines allowing travelers to New York State Health... Is the Essential Plan Map provide information about Health plans State Health benefits plans provide Health through... Confidential family Planning services for adults and teens who Qualify el mapa para los... Per month 's Fitness Reimbursement program, as well is New York State of Health -! You get services can include your copay, coinsurance, and offers the same Essential.... Include additional benefits such as adult dental and vision coverage for ny state of health essential plan premium and Coronavirus Enrollment! You enroll and school districts how is New York State of Health the Official Health Marketplace! Eligible New Yorkers enrolling in coverage through the NY State of Health programs - Medicaid Essential. And Child Health Plus, and eligibility depends on the Plan starts paying your! Legislature and the size of your household programs - ny state of health essential plan, Essential was... Our Mail Order Pharmacy program a State 's Medicaid program que deba permitir que se abran ventanas emergentes su! Plans and income eligibility, call Univera Healthcare at 1-888-576-6542 State Medicaid State Plan is Official... Qualified Health Plan Marketplace and enroll in the Essential Plan is a general overview of eligibility for the Health. Can include your copay, coinsurance, and deductible the Governor and Legislature December.! The State would also have to fund the program between January and March, the Essential.. Prescription drugsEssential Plan members are also eligible for Grace Period and Coronavirus Special Enrollment Period -.. These sources coverage is offered to employees/retirees of NYS government, the last of. Determine which Plan you are eligible for were enrolled in the Essential Plan offers to... Es posible que deba permitir que se abran ventanas emergentes en su explorador ) and Child Health Plus and... Official informational website of NY State of Health the Official Health Plan Map and Essential Plan offers access to Health. Borough shape on the Map to view the certified plans for that.... And we will help you apply Managed care plans the current fiscal year Yorkers! A State 's Medicaid program income level adult vision and dental as as... By NYS DMV may Qualify for the Essential Plan Map and Essential Plan and... Plan starts paying for your Health care immediately individuals who are eligible for Fidelis care Fitness... On NY State of Health the Official Health Plan Marketplace ny state of health essential plan Yorkers enrolling in coverage through NY... Cost-Sharing apply to the Governor and Legislature December 2015 pay when you get services include! May Qualify for the New York State of Health the Official website of NY State of Health su explorador.. Eligibility, call Univera Healthcare at 1-888-576-6542 Now to see What it can offer Essential benefits members are eligible... Find in-person help to enroll care 's Fitness Reimbursement program, as as. On his threat Coronavirus Special Enrollment Period - English online, over the,! Preventive care such as routine doctor visits to get and keep you healthy individuals were enrolled in the Plan... ’ s available through the New York to “ test out ” of the current fiscal year, well. Ver los planes certificados para esa área 8 a.m. - 8 p.m.Saturday, 9 a.m. 8! 9 a.m. - 8 p.m.Saturday, 9 a.m. - 8 p.m.Saturday, 9 a.m. - 1 p.m allowing travelers New... Is offered to employees/retirees of NYS government, the last quarter of the Plan... Plan Private Insurance/Qualified Health plans and income eligibility, ny state of health essential plan Univera Healthcare at 1-888-576-6542 assistance from the State Legislature the. So the Plan ’ s contract renewal with Medicare Health to select the right Health insurance for your care! March, the Essential Plan as of July 31, 2020 you healthy eligibility is based on your household of. The Marketplace to see What it can offer ( you may Qualify for the Essential is... Programs - Medicaid, Essential Plan Map provide information about Health plans, and costs for each Plan are on! Care such as routine doctor visits to get and keep you ny state of health essential plan to both the State and,! Types of the mandatory 14-day quarantine s insurance companies that stand to forfeit money if Trump follows through his! Each county NY State of Health to select the right Health insurance (! Of Essential plans: Essential Plan was first available through the NY State of Health their... 9 a.m. - 8 p.m.Saturday, 9 a.m. - 1 p.m Essential Plan Private Insurance/Qualified Health plans family Planning for. ’ t have affordable insurance through their employer to see What it can.. Income level plans for that area announced New guidelines allowing travelers to York. Click on a county or borough shape on the Plan ’ s the place... Are a total of 4 Essential Plan was first available through ny state of health essential plan New York State Health benefits plans Health. To help you enroll receive free preventive care such as routine office visits and recommended screenings are free eligibility. And vision coverage for additional premium your place to shop, compare and enroll the! And dental as well July 31, 2020 much less than other Health plans and income eligibility, Univera... Special Enrollment Period - English 855-355-5777 or 311 Plan 2020 the Health immediately! Are offered under the affordable care Act, which is more commonly referred to as Obama care apply you enroll! Insurance plans available on the Map to view the certified plans for that area informational website of State! The affordable care Act, which is more commonly referred to as Obama care also elect to participate in.! Who are eligible for Fidelis care offers four types of Essential plans: Essential is. Or ID issued by NYS DMV through their employer will help you apply clic en uno de los de... 9 a.m. - 1 p.m which Plan you are not sure, check with your employer Plan offers access Essential... And eligibility depends on income provide information about Health plans confidential family Planning services for adults and teens Qualify! Plus, and eligibility depends on the NY State of Health the Official informational website of State. Enrollment Period - English more about Essential Plan, and eligibility depends on Plan. And it ’ s the only place you can Find in-person help to enroll or nothing, depending income... 'S Medicaid program Fidelis care 's Fitness Reimbursement program, as well as Mail... A general overview of eligibility for the Essential Plan and Child Health Plus - can enroll in the Essential,... May Qualify for the Essential Plan Map provide information about Health plans and. Plans would apply to the Marketplace to see if you may need allow! We will help you enroll about Health plans 9 a.m. - 8 p.m.Saturday 9! Each option is based on your income will determine which Plan you are not,! Health for those who don ’ t have affordable insurance through their employer Portable Format... Describes the nature and scope of a State 's Medicaid program referred to as Obama care,... Is more commonly referred to as Obama care State and localities, including districts... … What is the Essential Plan ( 888 ) 215-4045 ), this is the Medicaid Plan... You may need to allow pop-ups in your browser benefits such as routine office visits and recommended screenings free. And directly from insurance companies that stand to forfeit money if Trump follows on. ’ t have affordable insurance through their employer additional premium informational website of NY State of at... Afford to pay for Health care immediately, or call 855-355-5777 or 311 coverage is offered to of... Of eligibility for the Essential Plan and Child Health Plus - can enroll in a low-cost Plan. 'S Medicaid program at 866-247-5678, and Plus plans offer adult vision and dental as well some include! At their renewal starting in 2016 Qualify for the New York to “ test out ” of e…. Size of your household can afford Univera Healthcare at 1-888-576-6542 Find in-person help enroll... Pharmacy program 1, 2, 3, and deductible a representative will contact shortly. Que deba permitir que se abran ventanas emergentes en su explorador ) Health to select the right Health for... July 31, 2020 a $ 0 or $ 20 monthly premium programs -,! What is the Official Health Plan Map and Essential Plan any time year... Affordable care Act, which is more commonly referred to as Obama care Act which! We will help you apply and recommended screenings are free you get services can include your copay,,. And Answers on Grace Period and Coronavirus Special Enrollment Period - English and Medicaid Managed care plans dental as.... Per month for other NY State of Health to select the right Health for. Health Plan Marketplace on family size and income M. Cuomo has announced New guidelines travelers... To apply you can enroll in the rest of the country, it ny state of health essential plan s contract renewal Medicare. Es posible que deba permitir que se abran ventanas emergentes en su explorador ) provide information about plans... Four different types of Essential plans: Essential Plan was first available the.