Free and Low-Cost Health Coverage in New York City

Start with the three facts that sort you

Income, age, status. Everything on this page routes off those.

Income is measured as household income against the federal poverty level, which is the yardstick every program here uses. For 2026, 100% of the federal poverty level is $15,960 for one person, and each additional household member adds $5,680. Programs then set their cutoffs as a percentage of that.

Each additional person adds $5,680 to 100% FPL. Annual figures.

Age matters because the programs split at 19 and again at 65. Under 19 is Child Health Plus or Medicaid territory. From 19 to 64 is where Medicaid and the Essential Plan sit. At 65 the rules change again and the application usually moves out of the marketplace entirely.

Immigration status decides which of these doors is open, and it closes fewer of them than people assume. That assumption is the single most expensive mistake in this subject, because families skip care they qualified for the whole time.

Your situation, and the door that fits it

One application at NY State of Health covers the first three rows at once. You do not select the program. You enter household size and income, and the application places you.

Medicaid: the widest program, and the one people abandon by accident

Medicaid covers more than anything else in the state: doctor visits, hospital care, prescriptions, labs, imaging, mental health and substance use treatment, dental, vision, and long-term care, which no other program on this page covers at all.

For most working-age adults without dependent children, eligibility runs to roughly 138% of the federal poverty level, about $22,025 a year for one person in 2026. Pregnant women and children qualify at substantially higher incomes, which is why ruling yourself out on the adult number is the wrong move.

Adults 65 and older, and people applying based on disability, follow a different set of rules that include asset tests, and they apply through their local department of social services rather than the marketplace.

The Essential Plan: $0 a month above the Medicaid line

The Essential Plan is state-run coverage for people who earn slightly too much for Medicaid. Premium: $0. Deductible: none. It covers doctors, hospital care, prescriptions, labs and mental health care, and most enrollees also get dental and vision.

The conditions are age 19 to 64, New York residence, lawful presence, income at or below 200% of the federal poverty level, and not qualifying for Medicaid. Applications are accepted every month of the year, so being told you “missed open enrollment” is a statement about marketplace plans and not about this one.

One change is worth knowing about because it caught people mid-year. The Essential Plan used to reach 250% of the federal poverty level. That tier ended July 1, 2026 when its federal funding ended, and roughly 360,000 New Yorkers moved to marketplace plans with tax credits. Below 200%, nothing changed. What to do if you were in that band.

Child Health Plus: the door that does not ask about status

Children under 19 are covered in New York regardless of immigration status, through Medicaid or Child Health Plus depending on family income. Family income limits for children run substantially higher than adult limits, so a household that is too well off for adult Medicaid frequently still has covered kids.

There is no enrollment season. You can apply in February or in July.

The situation this creates is common and worth naming: parents uninsured, children covered. That is not a failure of the system, it is how the thresholds are drawn. It also means the parents should keep applying, because NYC Care has no status requirement and hospital financial assistance is available to them regardless. The full Child Health Plus walkthrough.

NYC Care: access without insurance

NYC Care is not insurance. It is a membership program run by NYC Health + Hospitals that gives uninsured New Yorkers access to the city’s public system: eleven public hospitals plus the Gotham Health network of clinics.

There is no immigration status requirement and no income threshold for membership. At or below 200% of the federal poverty level, care costs nothing. Between 201% and 400%, you pay on a sliding scale, typically in the range of $20 to $30 for a clinic visit. Membership brings a primary care doctor, referrals to specialists inside the system, low-cost prescriptions, mental health care, sexual and reproductive health care, and a 24-hour line.

Enroll by phone at 1-646-692-2273. There is no deadline. Bring identification (passport, IDNYC, consular ID), proof that you live in the city, and proof of income, which can be a self-attestation if you are paid in cash.

The boundary: the card works inside NYC Health + Hospitals and nowhere else.

Community health centers and the sliding fee scale

Federally funded community health centers serve patients regardless of ability to pay, and set fees on a sliding scale tied to household income. They are the practical answer to “I need a doctor this month and my application is still pending.” Many also handle enrollment help on site.

We do not publish clinic lists here, because addresses, hours and services change faster than any article, and a stale list sends someone across the borough for nothing. The federal directory is the current one: findahealthcenter.hrsa.gov.

Two sentences to use when you call, before you book anything:

“Do you offer a sliding fee scale, and what do you need from me to set my fee?”

“I don’t have insurance yet. Can you tell me what today’s visit will cost me before I come in?”

Write down the name of whoever answers. Fee determinations get made at a front desk, and a name shortens the second conversation considerably.

Hospital financial assistance: the one that works backwards

Every hospital in New York State, including for-profit hospitals, is required by state law to run a financial assistance program. It is the only item on this page that helps with care you already received.

The floor set by state law:

Immigration status is prohibited from being considered. You can apply at any stage of the billing process, including after the account has gone to a collection agency. And the state minimum is a floor rather than a ceiling: many hospitals give more through the Indigent Care Pool, so always ask for the hospital’s own written policy instead of assuming the legal minimum is the offer. How to run that application.

Emergency care, and the program attached to it

An emergency room must screen and stabilize anyone who arrives, regardless of insurance, ability to pay or immigration status. That is federal law. It is not a promise that the visit is free, and a bill can follow, at which point the financial assistance rules above are what you use.

Emergency Medicaid exists for a specific gap: people who meet Medicaid’s income rules but not its immigration status rules. It covers treatment of an emergency condition, including childbirth. It is arranged through the hospital, usually after care is given, through a social worker or the financial assistance office. Ask for that office by name before you leave the building, and ask again in writing if the bill arrives first. More on care and immigration status.

Where this map runs out

Three honest limits.

Dental, vision and hearing for adults vary by program, and coverage that exists on paper can be thin in practice because fewer providers participate. Expect to make more calls than you would for a medical appointment.

“Free” describes the premium, not always the visit. Medicaid and the Essential Plan have no monthly cost, and small copays can still appear for some services depending on your income band. Check the plan documents you receive after enrollment rather than assuming either extreme.

Nothing here fixes a network problem. Whether a specific doctor takes a specific plan changes constantly, and no article can hold that current. Call the practice with the exact plan name in hand, every time. If you are uninsured right now, start here.