The Essential Plan is a program for eligible New Yorkers enrolling in coverage through the NY State of Health. The Essential Plan covers all of the essential health benefits covered under the Qualified Health Plans offered on the Marketplace, including inpatient and outpatient care, physician services, diagnostic services and prescription drugs among others, with no annual deductible and low out-of-pocket costs.
Now that you’ve enrolled in a health plan through NY State of Health, you may have some questions about how to use your health plan coverage. Here are some resources with answers to the questions you may have:
Brokers who wish to sell health insurance through NY State of Health (NYSOH) Marketplace, must be currently licensed by the Department of Financial Services (DFS) and certified by NY State of Health (NYSOH) marketplace. Effective August 31, 2020 NYSOH broker certification courses will be administered by NYSOH completely online and free of charge. The old NYSOH registration process on the DFS self-service portal will be shut off beginning August 28, 2020.
Under federal rules, state Marketplaces are required to undergo an annual independent external financial and programmatic audit. NY State of Health's Programmatic and Financial Audits are available here.
On July 23, 2020, the Department of Health issued its invitation to New York State Licensed Home Care Services Agencies (LHCSAs) to participate in the “NY State of Health Private Pay Home Care Services Program Pilot” in the counties of Nassau, Suffolk, and Westchester in 2021.
This Invitation is part of New York State Department of Health’s implementation of the recommendation by the Medicaid Redesign Team II, which was included in the SFY 2020-21 Enacted Budget, to