There is a new insurance option called the Essential Plan for eligible New Yorkers enrolling in coverage through the NY State of Health.
The Essential Plan covers all of the essential health benefits covered under the Qualified Health Plans offered on the Marketplace that you can get through health insurance open enrollment, including inpatient and outpatient care, physician services, diagnostic services and prescription drugs among others, with no annual deductible and low out-of-pocket costs. Preventive care such as routine office visits and recommended screenings are free.
Eligible consumers will pay either $20 monthly premium or nothing, depending on income. Some plans include additional benefits such as adult dental and vision coverage for additional premium. Essentially, this is a new health plan for New Yorkers that offers the same essential benefits but at a much lower cost.
Do you have more questions on what the Essential Plan is and how you can get it? Here are some frequently asked questions you might have:
Who can buy the Essential Plan?Lower-income people who don’t qualify for Medicaid or Child Health Plus.
Most you can make
How much does it cost?
Either $20 a month per person - less than a dollar a day - or nothing!
How else is the Essential Plan great?
The plan has no deductible, so it starts paying for your health care right away. You also get free preventive care like routine doctor exams and screenings to keep you healthy.
What does the Essential Plan cover?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
Do I have to enroll during the health insurance open enrollment period?Enrollment in the Essential Plan begins November 1, 2015 for coverage beginning January 1, 2016. From then on, eligible individuals will be able to enroll all year long, not just during the Marketplace’s Open Enrollment period.
This sounds great! How do I enroll?There are three ways you can enroll for the Essential Plan:
- If you have more questions, or you would just like someone to walk through the application process with you, our Apicha New York state-certified health insurance navigators would be more than willing to help you apply for health insurance. You can reach them by calling 1.866.APICHA9.Go online at nystateofhealth.ny.gov
- Call 1-855-355-5777 or TTY: 1-800-662-1220
- Through free help from a certified in-person assistor such as Apicha CHC.