Essential Plan

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All the Essential Benefits for Less

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. It’s available through the NY State of Health for those who don’t have affordable insurance through their employer. Eligibility is based on your income and the size of your household. For more information, call us at 1-888-679-7105 or visit the NYSOH.

What's Included?

• Coverage accepted by a large network of doctors and hospitals in your area
• FREE preventive care, including check-ups, flu shots, vaccines, screenings and more
• ExerciseRewards- earn up to $400 a year for working out
• Easy access to care 24/7 with our telemedicine program powered by MDLIVE

• Learn More About Essential Plan
• Estimate Treatment Costs with FAIR Health

Select Summary of Benefits & Coverage and Contract/Other Legal Information to view:

If you are single, over age 19 and your income is between $19,141 and $25,520 view:

Essential Plan 1

• Summary of Benefits & CoverageOpen a PDF
• Member ContractOpen a PDF
• Summary of Benefits & Coverage for American Indian/Native AlaskanOpen a PDF
• Member Contract for American Indian/Native AlaskanOpen a PDF

Essential Plan 1 Plus Vision & Dental

• Monthly premium rates for this plan vary based upon the county you live in. Please call for more information.

• Summary of Benefits & CoverageOpen a PDF
• Member ContractOpen a PDF
• Summary of Benefits & Coverage for American Indian/Native AlaskanOpen a PDF
• Member Contract for American Indian/Native AlaskanOpen a PDF

If you are single, over age 19 and your income is between $17,610 and $19,140 view:

Essential Plan 2

• Summary of Benefits & CoverageOpen a PDF
• Member ContractOpen a PDF
• Summary of Benefits & Coverage for American Indian/Native AlaskanOpen a PDF
• Member Contract for American Indian/Native AlaskanOpen a PDF

Essential Plan 2 Plus Vision & Dental

• Monthly premium rates for this plan vary based upon the county you live in. Please call for more information.

• Summary of Benefits & CoverageOpen a PDF
• Member ContractOpen a PDF
• Summary of Benefits & Coverage for American Indian/Native AlaskanOpen a PDF
• Member Contract for American Indian/Native AlaskanOpen a PDF

If you are single, over age 21, do not qualify for Medicaid based on immigration status* and your income is between $12,760 and $17,609 view:

Essential Plan 3

• Summary of Benefits & CoverageOpen a PDF
• Member ContractOpen a PDF

If you are single, over age 21, do not qualify for Medicaid based on immigration status* and your income is less than $12,759 view:

Essential Plan 4

• Summary of Benefits & CoverageOpen a PDF
• Member ContractOpen a PDF

* Must be a lawfully present immigrant (“Qualified non-citizen” immigration status without a waiting period; Humanitarian statuses or circumstances (including Temporary Protected Status, Special Juvenile Status, asylum applicants, Convention Against Torture, victims of trafficking); Valid non-immigration visas; Legal status conferred by other laws (temporary resident status, LIFE Act, Family Unity individuals). To see a full list of eligible immigration statuses, please visit the web site at www.healthcare.gov/immigrants/immigration-status/ or call the NY State of Health at 1-855-355-5777.