Definitive Guide

The Benefits of $0 Health Insurance

When you hear about free health insurance, you might wonder if $0 health insurance is for real. Rest assured that free health insurance is indeed very real.

“There are several free health insurance options in New York,” explains Dr. Sanjiv S. Shah, MetroPlusHealth’s Chief Medical Officer. “These plans are designed to fill the gap between federal programs like Medicaid and private health insurance.”

Free and low-cost health insurance is certainly great, but only if it meets your health care needs. Here’s a look at $0 health insurance, what it covers, who qualifies, and how to get free health insurance if you do.

“There are several free health insurance options in New York. These plans are designed to fill the gap between federal programs like Medicaid and private health insurance.”

Dr. Sanjiv S. Shah

MetroPlusHealth’s Chief Medical Officer

What is health insurance and why do I need it?

Health insurance is similar to other types of insurance like car insurance. It’s an agreement between you and a health insurer—you pay them a monthly premium in exchange for them covering “some or all of your health care costs,” explains HealthCare.gov.

However, not every health insurance plan requires payment in exchange for coverage. There are both federal and state programs that offer $0 health insurance to individuals and families who qualify.

Free health insurance is offered by New York State to adults and children from income-qualified households, from New York City to Niagara Falls and everywhere in between. Two of the most common $0 plans are the Essential Plan and Child Health Plus.

Who is eligible for $0 health insurance in New York?

Whether or not you’re eligible for free or low-cost health insurance depends on the requirements of each specific plan.

This year, thousands more New Yorkers will qualify for $0 health insurance. If you weren’t eligible before and now you are, you might be wondering what changed to make me eligible for $0 health insurance? The answer is that regulations changed.

Previously, in order to qualify for free health insurance in New York City and beyond, New Yorkers could earn no more than 200% of the federal poverty line. As of April 1, 2024, New Yorkers can now qualify for the Essential Plan if they earn up to 250% of the federal poverty line.

To qualify for the Essential Plan, you must:

Be a resident of New York State
Be a legal resident of the United States
Be between 19–64 years old
Not be eligible for Medicaid or Child Health Plus plans
Not be eligible for employer-based or other health insurance options

To qualify for Child Health Plus, a child must:

Be under the age of 19
Live in New York State
Not be eligible for Medicaid
Not covered by other health insurance
Not eligible for other state benefit programs (like NYSHIP)

Both the Essential Plan and Child Health Plus offer both $0 and low-cost options. Whether or not you qualify for the free plan or the low-cost plan depends on your family size and income.

Understanding $0 health insurance coverage in New York

Ok, you qualify for $0 health insurance in New York. Great! The next question is, what benefits are included in free health insurance? Let’s break it down by plan:

The Essential Plan

The Essential Plan covers many of the same services as other health insurance plans. Here’s a look at some of the specific care and services covered under the Essential Plan:

Preventative care
Emergency care
Prescription drugs
Mental health services
Urgent care
Dental and vision services
and more!

The Child Health Plus plan

Like the Essential Plan, Child Health Plus covers many of the same services as other health insurance plans. These services include:

Physical exams and immunizations
Well-child exams
Lab tests and imaging
Emergency care including ambulance transportation
Prescription and non-prescription drugs
Inpatient and hospital and surgical care
Inpatient and outpatient substance use and mental health services
Dental and vision care
Durable medical equipment
Hospice care

Common questions about free health insurance in New York

We get it—you still have questions. Who wouldn’t? It’s important to understand a health care plan before you sign on.

Here are answers to some common questions about free and low-cost health insurance in New York:

Can I Go to the Emergency Room With $0 Health Insurance?

Yes! Both the Essential Plan and Child Health Plus cover emergency room visits.

Can I Go to CityMD With $0 Health Insurance?

If you sign up for the Essential Plan through MetroPlusHealth, you can use it at CityMD.

Are Prescriptions Covered With $0 Health Insurance?

Yep! Both the Essential Plan and Child Plus Health cover prescription medication.

Are Vision and Dental Included in $0 Health Insurance?

Absolutely! Both dental and vision care are covered by the Essential Plan and Child Health Plus.

Using $0 health insurance in New York City

Where you can go with the $0 plan you have depends on the insurer you use to get your plan.

At MetroPlusHealth, we have an easy-to-use Provider Search tool that lets you see every provider and specialist available to you as a MetroPlusHealth member. Provider Search will let you know whether or not your current doctor is in-network with MetroPlusHealth, too.

Because these programs are income-qualified, you have to let the state know of any changes throughout the year that could impact your eligibility. These could include life changes like having a baby, getting married or divorced, or a change in your income. You have to report these changes whenever they happen, even if it’s in the middle of the year.

How do I apply for free health insurance in New York?

Ready to apply for free health insurance? If you’re wondering how to apply for $0 health care in New York City but don’t know where to start, MetroPlusHealth is here to help.

We’re always able to help you enroll in $0 health insurance or any other health care plan you’re interested in and qualify for. Just give our Member Services line a call at (855) 809-4073 or stop by one of our many offices throughout the five boroughs.

Got questions that aren’t about $0 health insurance? Call or see us with those, too.

“MetroPlusHealth was started by New Yorkers, for New Yorkers with a focus on people over profit,” says Dr. Tayla Schwartz, President and CEO of MetroPlusHealth. “We’re committed to helping New Yorkers live healthy lives, and that means helping them find the right insurance plan for them.”

Health insurance can be confusing no matter what. Income-qualified programs can be even more confusing because of their additional requirements. But putting in a little time and research can have big payoffs in the form of major cost savings on quality health care.

We’re always here to be a partner in your health care journey.

Just reach out!