Free health insurance in New York: who is eligible and under what conditions
'09.12.2021'
Lyudmila Balabay
Affiliate material
In 2021, the United States expanded the availability of preferential health insurance programs. Many people are aware of these changes, but do not fully understand their terms, so the most common question that insurance agents hear is about the level of income at which free insurance can be counted on. ForumDaily turned to the specialists of the New York insurance company Fidelis care asking you to explain who can get free health insurance in New York and on what terms.
Which insurance plans are free
If you need free health insurance in New York, check out the Essential Plan. There are four Essential Plan options, depending on the person's income and status. Moreover, all four options do not provide for monthly fees, that is, they are completely free.
Who has access to the Essential Plan options in New York State:
- Essential Plan 1 - people with income from 150% to 200% of the federal poverty level (FPL) This level is calculated for each year and differs depending on the composition of the family. Specific income figures for different families are shown below.
- Essential Plan 2 - persons with income from 138% to 150% of the FPL.
- Essential Plan 3 - Individuals with income between 100% and 138% of the FPL who are not eligible for Medicaid due to immigration status.
- Essential Plan 4 - Individuals with income below 100% of the FPL who are not eligible for Medicaid due to immigration status.
Explain all the requirements for registration Essential Plan can the specialists of the insurance company Fidelis care, consultation is available in Russian. Phone: (347) 642-2993, e-mail: [email protected]
Who can get the Essential Plan
Persons between the ages of 19 and 65 who meet income requirements and have legal immigration status in the United States are eligible to participate in the program. Fidelis Care offers the Essential Plan to individuals with the following incomes:
- Single-member families - up to $ 25 per year;
- Families of two - up to $ 34 per year;
- For families of three - up to $ 43 per year;
- Families of four - up to $ 53 per year.
What medical expenses are covered by Essential Plan
Under the Affordable Care Act (ACA or ObamaCare), all insured persons are guaranteed a certain level of minimum health coverage. The Essential Plan in New York covers 9 essential health services:
- Ambulatory treatment
- Emergency help
- Hospitalization (if you are in the hospital for more than 24 hours, fewer hours are covered by outpatient services - item 1).
- Maternity and newborn care
- Mental health and drug or alcohol treatment
- Prescription Drugs
- Rehabilitation services and devices (for example, physical therapy is one of the services, and a corset is an example of a device).
- Laboratory services (X-ray, computed tomography, ultrasound, etc.)
- Routine examinations or procedures
For more information on coverage options, contact insurance company specialists Fidelis care, consultation is available in Russian. Phone: (347) 642-2993, e-mail: [email protected]
In addition, all 4 New York Essential Plan 2022 options will include free dental and ophthalmic services.
The plan's free dental services include:
- Two cleanings a year
- Oral examinations, including x-rays
- Fillings
- Tooth extraction
- Emergency help
- Orthodontics
- Dentures
Free ophthalmic services covered by Essential Plan:
- One ophthalmologic examination per year
- Diagnostic examinations by an ophthalmologist
- Lenses or contact lenses once a year (more often if medically necessary)
To learn more about the Essential Plan, contact insurance company specialists Fidelis care... Among other things, they can help you find any other coverage plan that suits your needs and requirements. Consultation in Russian is available. Phone: (347) 642-2993, e-mail: [email protected]
Other free insurance options in New York
If you are not eligible for the Essential Plan, then Medicaid Managed Care may be the right plan for you. This is a program for New Yorkers who cannot afford to pay for health care. It does not provide for monthly insurance premiums, but it is not completely free of charge - for some services, the patient may be charged a small co-payment.
Who is Eligible for Medicaid
To be eligible for Medicaid Managed Care, you must be a resident of New York State for 5 years, have legal immigration status, and income up to 138% of the federal poverty level (specific amounts are listed below). Also, you should match one of the listed characteristics:
- to be pregnant;
- be responsible for a child under the age of 18;
- be blind;
- have a disability or a family member with a disability;
- be over 65 years old.
Medicaid Managed Care Income Levels:
- family of one person - up to $ 17 per year;
- family of two - up to $ 24 per year;
- family of three - up to $ 30 per year;
- family of four - up to $ 36 per year.
What services are covered by Medicaid Managed Care
Medicaid Managed Care covers doctor visits, pregnancy and childbirth, hospital admissions, and dental and ophthalmic services, and more.
Learn more about Medicaid Managed Care Plan you can ask the specialists of the insurance company Fidelis care... Consultation in Russian is available. Phone: (347) 642-2993, e-mail: [email protected]
