Health insurance in New York: NY State of Health, Essential Plan and Medicaid

When you can enroll

Outside Open Enrollment, you can buy a Qualified Health Plan after a life event like losing coverage, marriage or a birth. NY State of Health says you usually have 60 days before or 60 days after the event. See special enrollment periods.

The Essential Plan after July 1, 2026

The Essential Plan is New York's low-cost coverage for adults who earn too much for Medicaid. The New York State Department of Health says enrollees pay $0 in premiums and face minimal cost sharing.

• Who keeps it: about 1.3 million New Yorkers with incomes below 200% of the federal poverty level. Their eligibility continues under the federal Basic Health Program.
• What changed: federal law H.R. 1 cut funding for the expanded program. With federal approval, New York ended the expansion on July 1, 2026. About 450,000 people with incomes between 200% and 250% of the poverty level became ineligible.
• Where they go: the state says most of that group became eligible for Qualified Health Plans, which can have monthly premiums and higher deductibles even with tax credits. The state says it's working with insurers so anyone moving mid-year from the Essential Plan to a Qualified Health Plan sees their deductible cut in half.

Enhanced federal premium tax credits also expired at the end of 2025, which raised Qualified Health Plan costs for many New Yorkers in 2026. See premium tax credit.

Medicaid and Child Health Plus

• Medicaid, the Essential Plan and Child Health Plus can be applied for any time of year through NY State of Health.
• New for 2027: the New York State Department of Health says that starting January 1, 2027, some people with Medicaid will need to show they are working, going to school, helping out in the community or in job training to keep their coverage. This is a new federal rule. Watch for notices and renew on time.
• Children can apply for coverage any time during the year.

How to enroll, and where Gabriel fits

1. Gather your details: your household, expected income for the coverage year, any job-based coverage offer, and your doctors and prescriptions.
2. Apply at nystateofhealth.ny.gov, by phone at 1-855-355-5777 (TTY 1-800-662-1220), or with a free Certified Enrollment Assistor.
3. See what you qualify for: Medicaid, the Essential Plan, Child Health Plus or a Qualified Health Plan with tax credits.
4. Compare the premium after tax credits, the deductible, the out-of-pocket maximum and the network, then pay your first premium.

NY State of Health says it's the only place New Yorkers can get help paying for coverage through premium discounts or tax credits.

Gabriel can quote Marketplace plans for your ZIP code and household, show the price after any tax credit, and open your own application with a licensed agent in most states. You choose the plan and finish the application. Separate from insurance, Gabriel Core is $49 per adult a month (kids under 18 included) with member prices close to cost on lab tests, supplements, prescriptions and bioregulators, plus unlimited virtual urgent care and virtual primary care.

Gabriel is not an insurer. Health insurance quotes and enrollment are handled by Gabriel Labs, Gabriel's separately licensed insurance agency. Gabriel membership is not health insurance, doesn't count as minimum essential coverage, and doesn't replace a health plan's protection against large medical bills.