What is the maximum income to qualify for essential plan in ny 2022

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Essential Plan (with Adult Dental and Vision)
Who qualifies for NY essential plan?
What is the Medicaid income limit for 2022 in NY?
What is the New York State Essential plan?
What is the income cut off for Medicaid in NY?

Essential Plan (with Adult Dental and Vision)

EmblemHealth's Essential Plan is a no-deductible HMO plan with a $0 monthly premium. There are four versions of this plan, and eligibility depends on income and other factors. The Essential Plan is available at any time of year, but only if you enroll on the NY State of Health Marketplace. All Essential Plans offer adult vision and dental as well.

Who's eligible: Qualifying adult individuals age 19 to 64 (there is no family plan) living in one of eight New York counties, including the five New York City boroughs and Nassau, Suffolk, and Westchester counties.

Benefits, premiums (monthly cost), and out-of-pocket costs: All four versions of the Essential Plan include all the essential health benefits, but at different out-of-pocket costs. For benefits, view plan documents below.

Financial assistance: Cost savings are built into these plans through a premium of $0, no deductible, and copays as low as $0. No tax credits or additional financial assistance is offered with this plan.

dental
vision
Generic Drugs
telemedicine

$0 premium info	Pay $0 for your medical plan, depending on your income and other factors
No deductible info	Pay only a copay or nothing at all to use your health benefits
Low or no copays info	Pay as little as $0 to see a doctor or get your prescription medicine
Dental and vision coverage	Covered in full
$0 preventive care info	Fully covered. No out-of-pocket costs (no copay, coinsurance, or deductible) for your annual physical, immunizations, and screenings such as a colonoscopy and cervical screening
10 essential health benefits	Coverage for all services required under health care reform, such as doctor visits, hospital care, prescription drugs, lab services, maternity care, and mental health and substance use services
$0 telemedicine info	At no extra cost, consult doctors 24/7 about non-urgent medical needs, from a phone, computer, or tablet

Three-tier pharmacy benefits info	Coverage for generic (i) and brand-name medications, with your share of the costs
Gym reimbursement	Reimbursement up to $400 per calendar year
Wellness programs	Get help to eat better, quit smoking, manage a condition, or have a healthy pregnancy
Essential 1 copay (Primary care doctor/specialist/emergency room)	$15 / $25 / $75
Essential 2, 3, 4 copay (Primary care doctor/specialist/emergency room)	$0 / $0 / $0

Our Essential Plan provides network-only coverage through EmblemHealth's Enhanced Care Prime network.

Our Essential Plan is an HMO plan, which means you must:

Seek non-emergency care from doctors, hospitals and facilities in the Enhanced Care Prime network only, in order for your care to be covered
Choose a primary care physician (PCP) from the Enhanced Care Prime network. Members can choose or change their PCP by signing in to or registering for a secure online account or by calling 888-447-7703, Monday through Friday, from 8 am to 6 pm
Get a referral from your primary care physician in order to see network specialists

Benefit Summary - Essential Plan 1
Benefit Summary - Essential Plan 2
Benefit Summary - Essential Plan 3
Benefit Summary - Essential Plan 4

Summary of Benefits and Coverage - Essential Plan 1
Summary of Benefits and Coverage - Essential Plan 2
Summary of Benefits and Coverage - Essential Plan 3
Summary of Benefits and Coverage - Essential Plan 4

Subscriber Contract - Essential Plan 1
Subscriber Contract - Essential Plan 2
Subscriber Contract - Essential Plan 3
Subscriber Contract - Essential Plan 4

Since our Individual/Family and Essential Plans offer network-only coverage, members are responsible for the total cost of non-emergency care they receive outside their plan’s provider network.

Use the FAIR Health Calculator* to estimate the cost of non-emergency medical services and procedures by zip code.

*FAIR Health, Inc. is an independent nonprofit organization that uses actual provider charges when calculating fees. FAIR Health ensures that its fee information is accurate and complete. Please review the privacy policy and terms and conditions posted on the FAIR Health website.

Who qualifies for NY essential plan?

You are a NYS resident. Your monthly income in 2020 is below $2,127 for a single person or $4,367 for a family of four. You are a US/Naturalized Citizen or an immigrant present with the knowledge and consent of the US immigration service. You are between 19 and 64 years old.

What is the Medicaid income limit for 2022 in NY?

In 2022, the medically needy income limit is $934 / month for a single applicant and $1,367 / month for a couple.

What is the New York State Essential plan?

It covers comprehensive benefits, including dental and vision, inpatient and outpatient hospital care, prescription drugs and more. It also covers free preventive care like routine doctor exams and screenings to keep you healthy.