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Coverage

Every health coverage option available to New Yorkers — Medicaid, the Essential Plan, Child Health Plus, Medicare, marketplace plans, NYC Care — and who qualifies for which.

New York has more coverage options than almost any state, and that is exactly why people end up uninsured here: the door you need is open, but nobody tells you which door it is.

Three facts decide most of the answer: your household income against the federal poverty level, your age, and your immigration status. Everything below is organized around those three.

Start with the shortest path

If you want the answer before the reading, the eligibility navigator asks five questions and shows which programs are open to you. It runs in your browser, stores nothing, and links to the page for each program it names.

If you prefer the numbers directly: every 2026 income threshold, by household size.

The programs, by who they are for

Low income, any age — Medicaid. The broadest coverage in the state and the only one that covers long-term care. Roughly 138% of the federal poverty level for working-age adults, substantially higher for pregnant patients and children. Applications accepted every month of the year.

Ages 19–64, income up to 200% FPL — the Essential Plan. $0 monthly premium, no deductible, comprehensive benefits. Also year-round. Its upper tier was eliminated on July 1, 2026, which moved roughly 360,000 people to marketplace plans — what that means if you were among them.

Children under 19 — Child Health Plus. Covered regardless of immigration status, at family income limits well above the adult thresholds. Many households that qualify for nothing as adults qualify for their children.

Above the Essential Plan line — a marketplace plan through NY State of Health, with tax credits applied in advance to the premium. This is the one with a season: open enrollment runs November 1 to January 31.

65 and older — Medicare, on its own calendar: October 15 to December 7.

Uninsured with no path to insurance — NYC Care. Not insurance: access to the city’s public hospital system, with no immigration requirement and no income cutoff for membership. 1-646-NYC-CARE.

Union households — union plans work differently again, with their own networks and their own rules at the front desk.

The thing most people get wrong

Assuming they don’t qualify. New York’s rules are broader than most states’, and the single application at NY State of Health screens for everything at once. Most people who “know” they earn too much have never entered their actual numbers into an actual application.

Second most common: using last year’s income. Eligibility runs on projected income for the current year, and pre-tax deductions reduce the figure programs measure. See MAGI.

After you pick a program, pick a network

On Medicaid, the Essential Plan and Child Health Plus, the state sets the benefits and they are identical across carriers. What differs is which doctors are in network — and that is the decision you feel every time you book an appointment. How to check it in an hour.

If none of this arrives in time

Coverage is the long fix. If you are holding a bill right now, hospital financial assistance works on its own timeline: New York caps what an uninsured patient can be charged, immigration status may not be considered, and you can apply after the bill — including after it goes to collections.