What is Essential Plan?
ABOUT
Section 1331(a) of the Affordable Care Act (ACA) directs the Secretary of Health and Human Services to establish a Basic Health Program that provides a new option for states to offer health coverage for individuals with family incomes between 138 and 200 percent of the Federal Poverty Level (FPL) and for individuals with family incomes below 138 percent FPL who are lawfully present in the United States but do not qualify for Federally financed Medicaid due to their immigration status. The BHP is intended to offer a more affordable coverage option for individuals through existing State and Federal marketplaces. In March 2014, The Centers for Medicare and Medicaid Services (CMS) issued final regulations governing the Basic Health Program, which is branded as the Essential Plan in New York.
Simpler Health partners with New York State of Health and major insurance providers in New York to provide our customers the best service possible.
One Essential Plan for All your needs
The Product
Coverage for all services required under health care reform, such as doctor visits, hospital care, prescription drugs, lab services, maternity care, and mental health and substance use services
01
10 Essential Health Benefits
Fully covered preventive care. No out-of-pocket costs (no copay, coinsurance, or deductible) for your annual physical, immunizations, and screenings such as a colonoscopy and cervical screening
02
$0 Preventive Care
Dental and vision covered in full, including annual vision and dental exam, free glasses and lenses and so much more
03
Dental And Vision Coverage
Our Essential Plan does NOT require a referral for specialist visits and you can schedule directly with a specialist when you need it.
04
No Referrals
Needed
Exercise and get rewarded. Our Essential Plan offers reimbursement up to $400 per calendar year.
05
Gym Reimbursement
How do I enroll?
ENROLLMENT
Enroll the Essential Plan online
Simply click "Enroll Now" and follow the instruction to fill up the information. Our agents will reach out to you through email if we need additional information or if your application is approved.
Will Essential Plan impact my immigration status?
IMMIGRATION
"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."
nyc.gov
You're probably
wondering...
FAQ
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What is the Essential Plan?The Essential Plan is a health insurance sponsored by NY State of Health with no monthly premium and very low cost sharing. No deductible. Dental and vision included, inpatient and outpatient hospital care, prescription drugs and preventive care covered for qualified individuals.
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Why is it free? Is it a scam?It is free or with a low monthly premium because it is a program funded by the NY state government. It is not a scam and all information is available on government websites for verification. You can visit info.nystateofhealth.ny.gov/EssentialPlan or /www.nyc.gov
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Who can apply?New York State resident between 19 - 64 years of age, who meet income eligibility requirements. (Examples: single adults earning up to $25,520; adults in family of four earning up to $52,400; international students who don't make any income at school)
