Authorized Partner of the New York Department of Health
The $0 Essential Plan
Get affordable coverage for all your medical needs
Get affordable coverage for all your medical needs
The Essential Plan is a $0 health insurance program for New York residents. The program offers comprehensive coverage, including vision and dental care.
$0
Dental & Vision
Mental Health
Deductible
Preventive Care
Hospitalization
Maternity
$400
Gym Membership Reimbursement
$300
OTC Card for groceries and more*
100%
Co-insurance
Unlimited Maximum Benefit
*The $300 OTC card is only available to members enrolled in the UnitedHealthcare Essential Plan
Why is it free?
The Essential Plan is sponsored by the New York State government to offer comprehensive and affordable health coverage to all New York residents, including students and refugees.
Will it Affect my Immigration Status?
Applying for health insurance won't affect your immigration status or application for status. Your immigration status won't be shared with federal immigration authorities.
Interview with NYCDO Director, Max Hadler
As an officially authorized partner by the New York State Department of Health, Kimber Health was invited to the Office of Policy and Immigration Measures of the New York City Department of Health and Mental Hygiene for a special interview with Director Max Hadler. During the interview, we discussed important topics related to applying for and using the Essential Plan (EP). For those who want to know more, click to watch the interview video!
Eligibility
| EP 200-250 | EP 1 | EP 2 | EP 3 | EP 4 | |
|---|---|---|---|---|---|
| Income Qualifications | $30,120 - $37,650 | $22,590 - $30,120 | $20,783 - $22,590 | $15,060 - $20,783 | < $15,060 |
| Age Qualifications |
|
|
| 21-64 | 21-64 |
| Immigration Status | Everyone | Everyone | Everyone | Lawfully Present Immigrant | Lawfully Present Immigrant |
| EP 200-250 | EP 1 | EP 2 | EP 3 | EP 4 | |
|---|---|---|---|---|---|
| Premium | $0 | $0 | $0 | $0 | $0 |
| Deductible | $0 | $0 | $0 | $0 | $0 |
| Out-of-Pocket Limit | $2000 | $360 | $200 | $200 | $0 |
| Gym Membership Reimbursement | $400/year | $400/year | $400/year | $400/year | $400/year |
| Primary Care Office / Home Visits | $15 | $15 | $0 | $0 | $0 |
| Specialist Office / Home Visits | $25 | $25 | $0 | $0 | $0 |
| Preventive Care | Covered in full | Covered in full | Covered in full | Covered in full | Covered in full |
| Urgent Care Center | $25 | $25 | $0 | $0 | $0 |
| Emergency Care | $75 | $75 | $0 | $0 | $0 |
| Mental Health Care | $15 | $15 | $0 | $0 | $0 |
| Vision Care | $0 | $0 | $0 | $0 | $0 |
| Dental Care | $0 | $0 | $0 | $0 | $0 |
| Prescriptions (Retail Pharmacy) |
|
|
|
|
|
| OTC/Grocery Card | $75 per quarter | $75 per quarter | $75 per quarter | $75 per quarter | $75 per quarter |
| Download Brochure | Download | Download | Download | Download | Download |
Find a Doctor
Our Carriers
The Essential Plan is powered by our partner carriers below. You can find an in-network doctor or pharmacy for each provider below.
Get covered today!
Apply NowFrequently Asked Questions
01. Why is this plan $0?
This plan has been endorsed and subsidized by the New York State government. As such, those eligible for the plan may receive health insurance (including dental and vision care) at no cost.
02. What medical services does the Essential Plan cover?
The Essential Plan covers a comprehensive range of services known as Essential Health Benefits. In broad terms this includes: Doctor visits, including specialists, tests ordered by your doctor, prescription drugs, inpatient and outpatient care at hospital, physical examination, and dental and vision care. Additionally, the Essential Plan provides a $200 gym membership reimbursement to members who visit a qualifying gym 50 times in a 6 month period.
03. Will the plan provide out-of-state and foreign country insurance coverage?
As the Essential Plan is subsidized by the New York State government, only New York State medical centers are included. When you are outside the service area (outside of New York State), you are only covered for emergency and urgent care.
04. How much does it cost?
The Essential Plan is a subsidized healthcare program, and is provided at no cost to eligible individuals.
05. Who is eligible to enroll?
If you are an international student:
- Must be 21+ years old
- Must have a New York residential address
- Must have income below $37,650 annually.
06. Will enrollment in the Essential Plan affect my immigration/visa status (application for H1B)?
No, enrollment in the Essential Plan will not affect your immigration status as this is not a federal benefit. As the plan is provided by the New York State government, enrollment in the Essential Plan will not be reported to the federal immigration bureaus. After you have submitted your application, we will provide a letter stating that your immigration status will not be impacted. Here are resources from the New York City and State government stating that the Essential Plan will not affect immigration status.
Our Interview with Max Hadler (NYC Department of Health, Director of Policy and Immigration Initiatives): https://kimberhealth.com/plan/essential-plans
New York State: https://info.nystateofhealth.ny.gov/sites/default/files/NYSOH%20Public%20Charge%20Assistor%20QAs%20101119.pdf
New York City: https://www.nyc.gov/site/ochia/find-what-fits/immigrants.page
07. Do I need a Social Security Number (SSN) to apply for the Essential Plan?
No, a social security number is not required.
08. I currently hold an OPT visa status. Am I eligible for the Essential Plan?
Yes. Most OPT students qualify if they meet other eligibility requirements. These requirements include: 1) Being a New York resident, 2) Having no active coverage from any employer, 3) Having annual income below $37,650
09. I have already applied for OPT, but I have not received my EAD card yet. Am I still eligible for the Essential Plan?
Yes, you can apply for the Essential Plan without your EAD card.
10. I went to school in NY State, but now I’m working in a different state during my OPT period. Am I still eligible for the Essential Plan?
No, unfortunately the Essential Plan only covers New York State residents who have a permanent address in New York State.
11. I am a CPT, but I am not 21 yet; am I eligible for the Essential Plan?
You have to be at least 21 to be qualified.
12. Are there plans for students under 21?
Yes! Students under 21 can look into one of our affordable insurance plans.
13. How do I enroll in Essential Plan?
Enrollment in the Essential Plan can be completed on our site, at your convenience. Please fill out the form honestly and accurately. Any incongruence in your application will lead to delays.
14. Can I waive my university insurance with the Essential Plan?
To check if your university accepts the Essential Plan, please select your university in our onboarding application. If you are matched with the Essential Plan, then your university accepts the plan for waiver to the best of our knowledge.
15. How do I waive my school insurance with the Essential Plan?
The waiver process is highly dependent on the school. All schools require proof of insurance in different forms. Once your application is completed, we will send you waiver instructions to assist with the waiver process. If you have applied, but have not received waiver instructions, please reach out to us.
16. When is the enrollment period?
Enrollment is open year-round.
17. Can I cancel or change my plan anytime?
Yes, you can.
18. Under what circumstances will my plan terminate?
If your income rises above the required maximum for the essential plan, if you move out of New York State, or if you are unable to provide required address proof, immigration proof, or other pertinent information in a timely manner (generally within 1 month), you will no longer be eligible for the Essential Plan, and your insurance coverage ends accordingly.
19. How will I receive my insurance card?
The physical card will arrive to your mailbox in 2-3 weeks once you have been successfully enrolled.
Need your card earlier? Access your digital card.
UnitedHealthcare members:
1) Find your member ID within your portal or by contacting customer service.
2) With your member ID, register for an account here: https://www.healthsafe-id.com/rt/register/communityplan/en
3) Once registered, download your digital ID.
Can't locate your member ID? Call UnitedHealthcare at 1-866-263-1893.
Fidelis members:
1) Contact customer service to locate your "CIN Number."
2) Call 1-888-FIDELIS to request your member ID and report your name and CIN Number.
3) Using your member ID, register for an account here: https://members.fideliscare.org/fidelislogin?bypass=true
4) Once registered, download your digital ID.
Emblem Health members:
Please call 888-447-7703.
20. How long does it take to get my insurance card?
The physical card will arrive to your mailbox in 2-3 weeks once you have been successfully enrolled.
Need your card earlier? Access your digital card.
UnitedHealthcare members:
1) Find your member ID within your portal or by contacting customer service.
2) With your member ID, register for an account here: https://www.healthsafe-id.com/rt/register/communityplan/en
3) Once registered, download your digital ID.
Can't locate your member ID? Call UnitedHealthcare at 1-866-263-1893.
Fidelis members:
1) Contact customer service to locate your "CIN Number."
2) Call 1-888-FIDELIS to request your member ID and report your name and CIN Number.
3) Using your member ID, register for an account here: https://members.fideliscare.org/fidelislogin?bypass=true
4) Once registered, download your digital ID.
Emblem Health members:
Please call 888-447-7703.
21. How long do I have to live in New York State to qualify?
For visa holders (F1, J1, OPT, etc.), there are no restrictions. For green card holders or US citizens, there are no restrictions for Essential Plan 200-250/1/2; however, to qualify for Essential Plan 3/4, you need to have lived in New York for less than 5 years.
22. Do I need to show proof of residency when apply?
Generally, this isn't required. However, you will need to show proof of residency if the system can't verify your residential address.
23. Will the plan cover pregnancy and maternity?
Yes, as of 4/1/2024, the Essential Plan covers pregnancy and maternity, including childbirth.
24. When will the plan be effective?
Generally, the Essential Plan will be in effective in the month in which you applied. In some circumstances, the plan may begin in the next month.
25. How long does it take to process an application?
It usually takes 3-5 business days to process an application.
Hours of Operation :
Monday - Friday 9:00AM to 6:00PM EST
NYWPG is an Authorized Partner of the New York State of Health. License #1348502.
All information on this site is for reference only and is subject to change.
