Who is eligible for the Essential Plan?

There are just a few eligibility requirements that have to be met in order to qualify for the Essential Plan.

To qualify for the Essential Plan, you must:

  • Be a resident of New York State
  • Be a legal resident of the United States
  • Be between 19–64 years old
  • Not be eligible for Medicaid or Child Health Plus plans
  • Not be eligible for employer-based or other health insurance options

There are also income eligibility requirements for the Essential Plan, which expanded significantly this year to include many more New Yorkers.

Previously, in order to qualify New Yorkers could earn no more than 200% of the federal poverty line. As of April 1, 2024, New Yorkers can now qualify for the Essential Plan if they earn up to 250% of the federal poverty line.

The federal poverty line changes each year and depends on the size of your household. For 2024, New Yorkers are eligible for the Essential Plan based on these annual household income limits:

  • $30,120 for a single person
  • $40,880 for a family of two
  • $51,640 for a family of three
  • $62,400 for a family of four

Have more family members than that? Calculate your household’s income limit by adding $10,760 for each additional person.

PEOPLE IN HOUSEHOLD2024 MAXIMUM INCOME EFFECTIVE APRIL 1
1$37,650
2$51,100
3$64,550
4$78,000

 

last updated: March 29, 2024

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