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Health insurance for adults who don't qualify for Medicaid

Essential Plan | NYS Department of Health (NYSDOH)

Apply online

How it Works

The Essential Plan provides comprehensive health insurance benefits with $0 monthly premiums and low cost sharing.

  • Covers comprehensive benefits, including dental and vision, inpatient and outpatient hospital care, prescription drugs, and more.
  • Covers free preventive care like routine exams and screenings.
  • No deductible – the plan starts paying for your health care right away.
  • Has continuous open enrollment, meaning you can enroll at any time during the year through NY State of Health.

Determine your eligibility

You may be eligible if you’re:

  • An adult who is 19 – 64 years of age.
  • Not eligible for Medicaid or Child Health Plus
  • Not eligible for employer and other coverage
  • A New York State resident.
  • A U.S. citizen or meet immigration status requirements.
  • Meet these income eligibility requirements based on your household size:
Household size Yearly income Monthly income Weekly income
1 $37,650 $3,138 $724
2 $51,100 $4,259 $983
3 $64,550 $5,380 $1,242
4 $78,000 $6,500 $1,500
5 $91,450 $7,621 $1,759
6 $104,900 $8,742 $2,017
7 $118,350 $9,863 $2,276
8 $131,800 $10,984 $2,535
Each additional person, add: $13,450 $1,121 $259

 


What you need to include

You will need this information for each member of your family:

  • Birth dates
  • Social security numbers (for immigrants, numbers if you have them)
  • Employment, income, and health insurance information

How to apply

Apply by phone

Call 855-355-5777 or 311 to ask about applying to Essential Plan.

More information

Get enrollment help

GetCoveredNYC helps New Yorkers enroll in health insurance. Dedicated specialists can assist you in your language for free.


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Last Updated September 23, 2024