What is the maximum income to qualify for nys health insurance

Q: What is the maximum income to qualify for Medicaid in NY 2022?

The amount of allowable income changes each year, but its always extremely low. For example, in 2022, the monthly income limit for an individual was $934, while a married couple with both spouses applying for Medicaid could have only $1,367 in net income per month.

Q: Who qualifies for NY state of health?

The NY State of Health is mainly for: People who dont have insurance through a job or Medicare. New Yorkers under 65. New York Small Businesses with 100 or fewer employees.

Eligibility
Individuals may qualify if they are 19 to 64 years of age, a New York state resident, do not already have health insurance, and are not eligible for Medicaid.

Índice Show

Who qualifies for Essential Plan?
How much does Essential Plan cost?
What services will Essential Plan cover?
How do I enroll in Essential Plan?
More help before you apply
What is the Essential Plan?
Who is eligible?
How to apply
Helpful Links
What is the income limit for NY state of health?
What is the maximum income to qualify for Medicaid in NY 2022?
Who qualifies for NY state of health?
What is the monthly income limit for Medicaid in NY?

Household size	Most you can make
1 person	$27,180
2 people	$36,620
3 people	$46,060
4 people	$55,500

This chart is a general overview of eligibility for the Essential Plan. To find out exactly what you qualify for, call 1-866-MyCDPHP (1-866-692-3747).

The Essential Plan is available in 16 counties within the CDPHP service area: Albany, Broome, Clinton, Columbia, Essex, Franklin, Fulton, Greene, Montgomery, Rensselaer, Saratoga, Schenectady, Schoharie, Tioga, Warren, and Washington.

Cost details for each plan.

Essential Plan, also known as “EP” is affordable, comprehensive health insurance for low and moderate-income adults living in New York who are not eligible for Medicaid. EP is provided through managed care plans and offers essential health benefits. See the questions below to determine if you qualify for EP and if it is the best option for you.

Who qualifies for Essential Plan?

You may qualify for Essential Plan if:

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
You are not eligible for Medicaid or any other health plan

How much does Essential Plan cost?

Essential Plan has a monthly premium of $0 or $20 depending on your income. The Essential Plan has no deductible, and you can begin going to a doctor right away. You may pay a small fee called a co-payment for certain covered services.

What services will Essential Plan cover?

EP will cover essential health benefits (EHBs), including:

Free preventive care
Inpatient care
Outpatient services
Maternity and Newborn Care
Mental Health and Substance Abuse Disorders
Emergency services
Lab and imaging
Prescription drugs
Rehabilitative and habilitative services
Wellness and chronic disease management services

How do I enroll in Essential Plan?

You can enroll in person, online, or over the phone. If you need assistance enrolling into Essential Plan or want more information, please contact CHA at 888-614-5400.

Check if you might save on Marketplace premiums, or qualify for Medicaid or Children's Health Insurance Program (CHIP), based on your income. Or, find out who to include in your household and how to estimate income before you apply.

You'll get exact plan prices and savings by filling out a Marketplace application.

1. What state do you live in?

Select your state

2. How many people are in your household?

Include yourself, your spouse if married, and anyone you'll claim as a tax dependent in 2023 — even if they don't need coverage.

Select the number of people in your household

3. How much income will your household make this year?

Select the estimated income range for everyone you included in your household.

Select your income range

More help before you apply

Estimating your expected household income for 2023
- You can probably start with your household’s adjusted gross income and update it for expected changes. (Savings are based on your income estimate for the year you want coverage, not last year.)
- You may qualify to enroll in or change Marketplace coverage through a new Special Enrollment Period based on estimated household income. See if you may qualify.
- Use our income calculator to make your best estimate.
- Learn more about estimating income, and see what to include.
Including the right people in your household
- Count yourself, your spouse if you're married, plus everyone you'll claim as a tax dependent, including those who don’t need coverage.
- Learn more about who to include in your household.

What is the Essential Plan?

The Essential plan offers quality health insurance to working adults with lower incomes who do not qualify for Medicaid.

Who is eligible?

Adults may be eligible if they:

Are an adult who is 19 - 64 years of age. Individuals under 19 years old are eligible for Child Health Plus, not for the Essential Plan.
Are a New York State resident.
Meet income eligibility requirements. (Examples: single adults earning up to $25,520; adults in family of four earning up to $52,400)
Are U.S. citizens or meet immigration status requirements.
Meet certain income eligibility requirements tied to household size. View income levels for the Essential Plan.

How to apply

You can enroll in the Essential Plan any time of year. Apply online, over the phone, or in-person. Assistance is available in many languages. Visit the NY State of Health, or call 855-355-5777 or 311.
Find an in-person enroller near you.

Helpful Links

NY State of Health Marketplace
NYC Human Resources Administration
Essential Plan Fact Sheet

What is the income limit for NY state of health?

Meet income eligibility requirements. (Examples: single adults earning up to $25,520; adults in family of four earning up to $52,400)

What is the maximum income to qualify for Medicaid in NY 2022?

The amount of allowable income changes each year, but it's always extremely low. For example, in 2022, the monthly income limit for an individual was $934, while a married couple with both spouses applying for Medicaid could have only $1,367 in net income per month.

Who qualifies for NY state of health?

The NY State of Health is mainly for: People who don't have insurance through a job or Medicare. New Yorkers under 65. New York Small Businesses with 100 or fewer employees.

What is the monthly income limit for Medicaid in NY?

In 2022, the medically needy income limit is $934 / month for a single applicant and $1,367 / month for a couple. The “spend down” amount is the difference between one's monthly income and the medically needy income limit.