Important Update:
Essential Plan 200–250
Coverage Ending
Due to federal funding changes, Essential Plan 200–250 coverage will end on June 30, 2026. This means that members enrolled in the Essential Plan with a household income between 200–250% of the federal poverty level will lose coverage after June 30, 2026. That includes the following incomes:
- Single-person household: $31,920–$39,900
- 2-person household: $43,280–$54,100
- 3-person household: $54,640–$68,300
- 4-person household: $66,000–$82,500
If this applies to you, NY State of Health (NYSOH) has sent you a notice with more details, including your eligibility and next steps for getting new coverage.
To stay covered, you must review your notice and enroll in a new health plan.
Stay Covered – What You Need to Do
Frequently Asked Questions
Where can I get help?
You can:
- Visit nystateofhealth.ny.gov or call NYSOH at 1-855-355-5777 for more information
- Call MetroPlusHealth at 1-866-496-6636 for help choosing and enrolling in a plan
- Get help from a certified enrollment assistor
Will I be able to keep my doctor?
You can keep seeing your doctors and using your benefits through June 30, 2026.
After that, your doctors may depend on the plan you choose. Many doctors accept more than one type of plan, but you should check before enrolling.
What if I’m pregnant or recently had a baby?
If you are pregnant or recently had a baby, you may qualify for continued coverage or a different low-cost plan, such as Medicaid or another Essential Plan.
NY State of Health will review your situation and include details in your notice. If your pregnancy is not on file, contact NYSOH to update your information.
Can I get help paying for a plan?
Possibly. Many people qualify for financial help to lower monthly costs and other expenses.
The first step is to make sure your information with NY State of Health is up to date. They use this information to determine what coverage and savings you qualify for.
What plans can I get next?
NYSOH will determine your eligibility. You may qualify for other plan options, such as:
- Medicaid
- Another Essential Plan tier
- A Qualified Health Plan (QHP)
When should I enroll in a new plan?
You can enroll now. Enrolling soon will help make sure your new coverage starts July 1, 2026. Once your eligibility is determined, a MetroPlusHealth representative can help you enroll in a new plan at 1-866-496-6636.
Do I need to take action?
Yes. To stay covered, you must pick and enroll in a new health plan.
When does my coverage end?
Your Essential Plan 200–250 coverage ends June 30, 2026.