Termination of Essential Plan 200-250

This week, NY State of Health notified approximately 360,000 New Yorkers that their Essential Plan (EP) coverage will end on June 30, 2026. Due to recent federal policy changes that have negatively impacted New York State’s budget, the state is no longer able to provide Essential Plan coverage for individuals with incomes between 200% and 250% of the Federal Poverty Level (FPL).

The notification encourages affected members to make use of their Essential Plan benefits before coverage ends and includes information on accessing free or low-cost healthcare services across different regions of the state.

To support individuals during this transition, NY State of Health is referring individuals to the Community Service Society’s Community Health Advocates (CHA) program, which provides free assistance in exploring alternative health coverage options. CHA can be reached at 888-614-5400.

CHA can assist with determining whether individuals losing EP 200-250 coverage may qualify for Medicaid, Essential Plan coverage under lower income tiers (EP 1 or EP 2), or a Qualified Health Plan (QHP).  Individuals with incomes up to 250% FPL may be eligible for Advance Premium Tax Credits (APTCs) to help reduce the cost of QHP  through the Marketplace and those with incomes up to 400% FPL qualify for cost-sharing reductions, which can lower QHP out-of-pocket expenses such as deductibles, copayments, and coinsurance.