For purposes of these Terms and Conditions, “You” refers to the person who is enrolled in the Essential Plan and attested to having persistent asthma.
The Essential Plan Cooling Program (“EPCP”) is only for Essential Plan enrollees who meet the program requirements. Applicants must have Essential Plan coverage at the time of application and must have Essential Plan coverage on the first of the month following their application. Any false statements or other misrepresentation You knowingly make in connection with the application may result in You being found ineligible for this program.
By applying for the EPCP, You authorize NY State of Health to verify Your enrollment in Essential Plan. If any of the information You provide in this application does not match the NY State of Health database, NY State of Health may contact You for further information.
NY State of Health will keep Your eligibility and protected health information private as required by law. Your answers on this application will only be used to decide if You qualify for the EPCP. NY State of Health may share Your eligibility and protected health information with its contractors that administer the EPCP, if necessary to provide You with the benefits of the Program. NY State of Health’s contractors are required to keep Your personal information private. For more information about how NY State of Health uses, shares, and protects personally identifiable information, please visit NY State of Health | Privacy Resources.
Personal Privacy Law - Notification to Consumers: New York State’s Personal Privacy Protection Law, which took effect September 1, 1984, states that we must tell You what the State will do with the information You give us about yourself. We use the information to find out if You are eligible for the Essential Plan Cooling Program.
If You are eligible for the EPCP, You will need to select and contact an authorized HVAC vendor in the EPCP. You must provide the vendor with access to Your residence to assess the location, deliver, and install an air conditioner.
You may not receive more than one cooling unit per household over a five-year period.
You must tell NY State of Health if anything changes from what You provided on this application by using the following contact options to report any change or for help getting required information:
If You need help with any of the following, please call NY State of Health at 1-855-355-5777 (TTY: 1-800-662-1220)
obtaining your HX ID or AC number
if you need help filling out the application
If You need help with any of the following, please contact NYSoHCoolingProgram@health.ny.gov
if you want to withdraw your application
if you want to update your application, including after you received a notice that your application has been approved or denied, or before you have received approval or denial notice
if you are having trouble reaching an approved vendor
If Your residential or mailing address changes after you have applied for this program, you must contact NY State of Health at 1-855-355-5777 (TTY: 1-800-662-1220) to update your account. Once You have updated your address with NY State of Health You must notify EPCP by sending a confirmation email to NYSoHCoolingProgram@health.ny.gov
If you need help understanding this application because your primary language is not English, or because you have a disability that affects your ability to read or complete the application, please call 1-855-355-5777 (TTY: 1-800-662-1220). NY State of Health can provide you with an interpreter or auxiliary aids (such as TTY through New York Relay Service or written materials in an alternative format (large print, audio or data CD, or Braille)) for free to help you understand or complete the application.