Essential Plans

Plans with access to essential health benefits like doctor visits, lab tests, prescription drugs, hospitalization, urgent care, emergency care and more—plus, options for vision and dental benefits—all for a $0 or low monthly plan premium. These plans are for qualified individuals ages 19–64.

Plan Highlights:

  • No-cost annual checkups
  • Hospital, emergency room and urgent care visits
  • Lab tests and X-rays
  • Prescription drug coverage
  • Maternity and newborn coverage
  • Optional dental and vision coverage
  • 24/7 access to care with telemedicine
  • Physical, occupational, and speech therapy
  • Annual gym membership reimbursement**
  • 2019
Tier
Essential Plan 1
Essential Plan 1 Plus Vision & Dental
Summary of Benefits and Coverage (PDF)
English
English
Premium
Monthly premium costs depend on income Get a Quote
Eligible Age
19 to 64
Eligible Location
Within New York City’s five boroughs (the Bronx, Brooklyn, Manhattan, Queens, and Staten Island), Long Island, and Westchester, Sullivan, and Orange counties
Other Eligibility Requirements
Income between $18,210 and $24,280*
Dental Cleanings
Not covered
$15 copay
Vision Exams
Not covered
$15 copay
Teladoc
$0 copay
$0 copay
More Plan Information
Tier
Essential Plan 2
Essential Plan 2 Plus Vision & Dental
Summary of Benefits and Coverage (PDF)
English
English
Premium
Monthly premium costs depend on income Get a Quote
Eligible Age
19 to 64
Eligible Location
Within New York City’s five boroughs (the Bronx, Brooklyn, Manhattan, Queens, and Staten Island), Long Island, and Westchester, Sullivan, and Orange counties
Other Eligibility Requirements
Income between $16,753 and $18,210*
Dental Cleanings
Not covered
$15 copay
Vision Exams
Not covered
$15 copay
Teladoc
$0 copay
$0 copay
More Plan Information
Tier
Essential Plan 3
Summary of Benefits and Coverage (PDF)
English
Premium
$0
Eligible Age
19 to 64
Eligible Location
Within New York City’s five boroughs (the Bronx, Brooklyn, Manhattan, Queens, and Staten Island), Long Island, and Westchester, Sullivan, and Orange counties
Other Eligibility Requirements
Income between $12,140 and $16,753*
Requires legal U.S. residency for less than five years. Learn more about your legal status here.
Dental Cleanings
$0 copay
Vision Exams
$0 copay
Teladoc
$0 copay
More Plan Information
Tier
Essential Plan 4
Summary of Benefits and Coverage (PDF)
English
Premium
$0
Eligible Age
19 to 64
Eligible Location
Within New York City’s five boroughs (the Bronx, Brooklyn, Manhattan, Queens, and Staten Island), Long Island, and Westchester, Sullivan, and Orange counties
Other Eligibility Requirements
Income less than $12,140*
Requires legal U.S. residency for less than five years. Learn more about your legal status here.
Dental Cleanings
$0 copay
Vision Exams
$0 copay
Teladoc
$0 copay
More Plan Information

Additional Benefits

  • 24/7 Access to Telemedicine with Teladoc*

    Talk to a doctor any time—for a $0 copay. Connect with board-certified doctors through video chat or phone for prescriptions, help diagnosing and treating non-emergency conditions, and more. Access to dermatologists is also available.

  • Urgent Care Center Network

    Get the care you need when you need it at an urgent care center in our network—no appointment needed. Urgent care centers offer late-night and weekend hours, often with faster service at a lower cost than the Emergency Room (ER).

    Visit an in-network urgent care center to get help for non-emergency conditions like earache, upset stomach, sprains, stitches, and more.

  • Active & Fit Direct

    Working out just got easier. For just $25/month plus a one-time enrollment fee of $25, you can get a standard membership to a fitness center in your area. Track your activity, check your progress, reach your fitness goals, and so much more!

    Please note: a three-month membership commitment is required up front. Learn more about Active & Fit Direct.

  • Rewards for Working Out

    You can get rewarded for taking care of your health—up to $400 in a calendar year with the ExerciseRewards™ program**.

    It’s easy! Work out at a qualifying gym or fitness facility at least 50 times in a six-month period and track your workouts.Your spouse or domestic partner can be reimbursed too—up to $200 in a calendar year when he or she works out at least 50 times each six-month period in a calendar year.

    Learn more about ExerciseRewards™ or
    start earning your reward now!

Additional Benefits

  • 24/7 Access to Telemedicine with Teladoc*

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  • Urgent Care Center Network

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  • Active & Fit Direct

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  • Rewards for Working Out

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Frequently Asked
Questions

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Support When You Need It

We're happy to answer your questions.

Learn about enrollment

1-844-488-1486

Monday to Friday, 9am—8pm

TTY English: 1-888-542-3821

TTY Español: 1-888-867-4132

Member Services

1-888-250-2220

Monday to Friday, 8am—8pm

TTY English: 1-888-542-3821

TTY Español: 1-888-867-4132

Can't talk right now?

Request a callback and we’ll get back to you within one business day.

You can also visit us in person at our community offices.

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.