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

These dates: 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 Medcicaid?

200

An adult is not eligible for Medicaid, they are then screened for this plan

What is the Essential Plan?

200

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

What is a deductible?

200

How to get free enrollment assistance for people under 65 years old

What is Call 311 or Text

“CoveredNYC” (SeguroNYC en Español)

to 55676 

200

Now one month prior to applying for Medicaid

What is the new 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 medical services

What is NYC Care?

300

Now two months prior to applying for Medicaid

What is the new 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

The fixed amount you pay for covered medical services, such as a primary or specialist doctor visit, or prescription 

What is a co-payment?

400

Human Resources Administration determines the Medicaid eligibility for these people

Who are people 65+, disabled or blind?

400

Health insurance enrollment period for Essential Plan enrollees for coverage to begin July 1, 2026 

What is May 16, 2026 to June 15, 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

Hospitals and community health care centers accept payment from patients based on this payment arrangement

What is payment for medical care on a sliding fee scale?

500

Beginning in 2027 this age group must renew their Medicaid coverage twice per year 

Who are 19 – 64 year olds?