Medicaid & Essential Plans through NY State of Health

New York Essential Plan. The # 1 most inexpensive health plan in NY

The Essential Plan is a New York medical insurance program for state locals that do not receive Medicaid or the Child Health Plus Program. There are a total of four Essential Plan choices, and each alternative is based upon your family earnings level. Two of these Essential Plan options include dental and vision coverage, and the remaining two options provide you the opportunity to purchase oral and vision coverage as a rider. Premiums differ from $0 to $46 per month.

New York City State (NYS) produced this program to fill the coverage space that numerous individuals and families have as they do not get approved for Medicaid. However, they can not afford full premium coverage.

How to Enroll in the Essential Plan

Before Enrolling in an Essential plan, you might want to examine the eligibility requirements. Nevertheless, your alternatives to enroll include the following:

Contact us at our toll-free number 1-800-252-7047, and we will initially help you identify if you are qualified. When we determine your eligibility, we compare all of the readily available Health insurance businesses providing the essential plan in your region. Our contrast will ensure that your existing medical professional belongs to the network, along with comparing network size to figure out if the medical facilities and laboratories of your choice are included in the network.

You have the alternative to check out each carrier to evaluate their plans. Nevertheless, you won’t be able to compare strategies side by side.

The NYS of Health is another registration alternative. You can go direct, or we can register you in the plan that you choose.

What does the Essential Plan Cost?

There are a total of four Essential plan choices, and the premium is based upon eligibility, income, and if you include oral and vision coverage. There are no household plans with the essential plan, only private coverage. Children are not qualified for the Essential Plan. However, if the moms and dad(s) receive the Essential, then the kids are probably eligible for Child Health Plus (we offer Child Health Plus) registration services.

1. Essential Plan 1 – $20
2. Essential Plan 1 Plus (with Dental and Vision ) – $46
3. Essential Plan 2 – $0
4. Essential Plan 2 Plus (with Dental and Vision) – $26

Are You Eligible for the Essential Plan?

There are three qualifying components for you to be qualified for the NY Essential Plan. They are:

• Earnings requirements.
• Residency and Immigration Status.
• Aging In and Aging Out.
• Earnings limits belong to your household size. The following chart discusses how your income and family size is structured.

Essential Plan Residency Requirements

Low and moderate-income families that are locals of New York State and legal immigrants are qualified for the Essential Plan program.

Essential Plan 1 premiums are $20 per person each month. Essential Plan 2 expenses $0, yet plan advantages are generous and provide you the ten essential health benefits authorized by the Affordable Care Act. Following are the different variations of the NYS Essential Plan:

Essential Plan 1 – Individuals with income higher than 150% and less than or equal to 200% of the FPL.

Essential Plan 2 – Individuals with income higher than 138% and less than or equivalent to 150% of the FPL.

Essential Plan 3 – Individuals with income equivalent to or greater than 100% and less than or equal to 138% of the FPL and not eligible for Medicaid due to migration status.

Essential Plan 4 – Individuals with earnings listed below 100% of the FPL and not qualified for Medicaid due to immigration status.

Aging In & Aging Out of the Essential Plan

If you are an adult between 19 and 65, you can participate in the program. Children under age 19 may get approved for Child Health Plus, and Medicare typically covers those past age 65.

What Is Covered Under an Essential Plan?

Under the Affordable Care Act, a particular level of minimum coverage is guaranteed to all insured people. The NY State of Health Essential Plan also includes the same ten health essentials. These are:

1. Ambulatory patient services (outpatient care).
2. Emergency Services (given up an emergency room or immediate care center).
3. Hospitalization (when you remain in the healthcare facility for more than 24 hours, fewer hours are covered under ambulatory services).
4. Maternity and newborn care.
5. Mental health service and drug or alcoholism treatment (dealt with as any other medical illness).
6. Prescription drugs.
7. Corrective services and gadgets (e.g., Physical treatment is one of the services, and a brace is an example of a device).
8. Lab services including x-rays, CAT scans, ultrasounds, and such.
9. Preventative services.
10. Pediatric services (not appropriate to New York State Essential Plan as Child Health Plus covers kids under 19).