Public Health Insurance
Work Requirement
Terminology
Good to Know
Key Dates
100

All children are eligible for this program regardless of their immigration status

What is Child Health Plus?

100

Earn income AND complete hours of the approved activities

What is converting income to hours using the federal minimum wage ($7.25) to determine how many hours of approved activities are needed to reach 80 total hours to meet the Medicaid work requirement

100

This population is no longer eligibile for the Essential Plan and Qualified Health Plans.

What are DACA recipients?

100

This population will need to work or participate in approved activities or qualify for an exemption to retain Medicaid

What are adults 19 - 64 years old?

100

November 1, 2026 to December 31, 2026

What is the new open enrollment period for Qualified Health Plans

200

An undocumented adult can get this coverage

What is Medicaid for the treatment of an emergency medical condition? What is Emergency Medicaid? What is Medicaid?

200

Complete 80 hours of any combination of these approved activities in a month

What is Work - traditional or self-employment; Participation in community service; Participation in a work/job training program; Active enrollment in an educational program to meet the Medicaid work requirement

200

Under age 19; over 64, medically frail, former foster children, Parent, guardian, caretaker relative, or family caregiver of a dependent child age 13 or under

What are some exempted populations?

200

Enrollment into a Qualified Health Plan for this population will be available May 16 - August 30, 2026

What are people no longer eligible for the Essential Plan?

200

This benefit is available one month prior to applying for Medicaid

What is the retroactive coverage period for 19-64 year olds?

300

Enrollment is open all year long for these public health insurance programs?

What is Medicaid, Child Health Plus and the Essential Plan?

300

Earn a household income of at least $580 in a month or be a seasonal worker with a 6-month average income ≥ $580

What is one way to meet the Medicaid work requirement?

300

High-unemployment area and Declared emergency / disaster area

What are short-term county-based hardship exemptions?

300

A health care access program that provides its members free to low-cost services

NYC Care or H+H Options/HHC Options

300

Available two months prior to applying for Medicaid

What is the retroactive coverage period for individuals 65 and over, disabled, child under 19, or pregnant?

400

Adults 65 and over might be eligible for this program?

What is Medicaid or Medicare?

400

Will receive a notice of noncompliance

Who are members who are not exempt or do not meet work and community engagement requirements?

400

Institutional / high-acuity care and Extended travel for health care

What are short-term individual-based hardship exemptions?

400

Legal permanent residents (green card holders), Cuban/Haitian entrants and Citizens of the Freely Associated States

What are the categories of people who will be eligible for Medicaid and Medicare beginning October 2026?

400

Consumers will lose this coverage if not used for six months.

What is Medicaid for the Treatment of an Emergency Medical Condition or Emergency Medicaid?

500

This program's income eligibility will change in 2027 

What is the Essential Plan?

500

Blind or disabled, Substance use disorder, Disabling mental disorder, Serious or complex medical condition, Physical, intellectual, or developmental disability

What are medical frailty definitions that allow someone to be exempted from the work/community engagement requirement?

500

A federal law that allows someone to continue health insurance coverage offered by their former employer, usually for up to 18 months after leaving a job.  You must pay the full cost of your coverage plus you may be charged an administrative fee

What is COBRA?

500

Immigrants who are eligible because they are in the U.S. with the knowledge and permission of United States Citizenship and Immigration Services (USCIS).

What is PRUCOL? Permanently Residing Under Color of Law?

500

Must renew their Medciad coverage twice per year

Who are 19 – 64 year olds?

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