5 Essential Things You Should Know About the Essential Plan

The Essential Plan (EP) is a health plan for New York state residents who are not eligible for Medicaid, but are still in need of high quality health insurance coverage. Recently, the eligibility rules for Essential Plan were expanded, which means more New Yorkers than ever will qualify for coverage. Read below to learn more about the EP, and how to find out if you may be eligible.

1. What is included in the Essential Plan?

CDPHP Essential Plan comes with:

• FREE preventative care, like physicals and screenings
• Low or no copays for prescription drugs
• $0 cost share for dental and vision benefits
• Inpatient and outpatient care
• Diagnostic tests and imaging
• Pregnancy, maternity, and newborn care
• Mental health and substance use disorder services
• Fitness reimbursement
• Weight management

2. How much does it cost?

The monthly premium is $0 and there is no deducible. Plus, dental and vision benefits are included at no additional cost.

3. Who qualifies for the Essential Plan?

You may be eligible for the EP if you:

• Are between the ages of 19 and 64
• Do not already have health insurance
• Are not eligible for Medicaid

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).

4. When can you enroll?

Individuals can enroll in the EP at any time throughout the year, meaning you don’t need to wait for an open enrollment period to switch or enroll into an Essential Plan.

5. How can you find out if you qualify for the Essential Plan?

It’s easy! You can get started today. If you have questions, or want more information, you also call 1-866-692-3747.

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