Public Health Insurance
Eligibility
Terminology
Good to Know
H.R.1
100

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

What is Child Health Plus?

100

Income up to $1,836 per month

What is the income eligibility for a single person for Medicaid?

100

The amount you pay monthly to have health insurance coverage

What is a premium?

100

Free help to enroll in Medicaid, Medicare, Medicare Saving Programs and help to renew Medicaid

What is the Facilitated Enrollment for the Aged, Blind and Disabled Program?

100

November 1, 2026 to December 31, 2026

What is the new open enrollment period for Qualified Health Plan

200

An undocumented adult can get this coverage

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

200

A women pregnant with triplets, a husband and a 2-year old

What is a household size of 6?

200

The amount you must pay for covered health care services, before your health plan begins to pay

What is a deductible?

200

Free enrollment assistance for people under 65 years old

What is Call 311 or Text

“CoveredNYC” (SeguroNYC en Español)

to 55676 

200

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

18 years old or younger, 65 years old or older, Pregnant, or were pregnant in the last 12 months

Who are some of the people exempted for the community engagement/work requirement?

300

The doctors, hospitals, and clinics that contract with an insurance plan to provide care at agreed on costs

What is a provider network?

300

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

NYC Care

300

Two months prior to applying for Medcaid

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?

400

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

What are the categories of people who are eligible for Medicaid and Medicare?

400

Does not usually require a referral and offers more flexibility when using your coverage

What is a PPO-Preferred Provider Organization?

400

These individuals Medicaid eligibility is determined by the Human Resources Adminsitration

Who are people 65+, disabled or blind?

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?

500

This program's income eligibility will change in 2027 

What is the Essential Plan?

500

Must meet 80-hour work requirement

Who are Medicaid expansion adults 19-64 years old who do not have an exemption?

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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