The Essential Plan
New York's program for moderate-income residents who earn too much for Medicaid: low or no monthly premium and low cost-sharing, with year-round enrollment for those who qualify.
Health Insurance in New York
NY State of Health marketplace plans, the Essential Plan, and family or small-group coverage — compared by cost, network, and subsidy eligibility for your county.
Quick answer
Compare New York health insurance through NY State of Health: marketplace plans, the Essential Plan, subsidies, carrier participation by region, and enrollment windows — with independent broker guidance.
Bee Health Insured helps shoppers compare coverage options with practical guidance before choosing a plan. Availability, eligibility, and enrollment support depend on the state, carrier, product, and licensed producer involved.
Last reviewed: June 10, 2026
Official marketplace
NY State of Health
The official health insurance marketplace where eligible shoppers compare plans, apply subsidies, and complete enrollment.
Visit NY State of Health →Open enrollment window
Mid-November – January 31
New York sets its own open enrollment dates, historically longer than the federal window. Verify the current plan year's exact dates with NY State of Health. Essential Plan and Medicaid enrollment is year-round for those who qualify.
Child Health Plus
Coverage for children with sliding-scale premiums based on household income, available regardless of immigration status.
APTC subsidies
Income-based Advance Premium Tax Credits lower the monthly premium of marketplace Qualified Health Plans; eligibility is determined when you apply through NY State of Health.
Community rating
New York individual-market premiums do not vary by age or tobacco use, which changes how plans compare for younger and older shoppers.
Marketplace carriers to compare
| Carrier | Where it participates | What to check |
|---|---|---|
| Fidelis Care | Statewide footprint in many counties | Confirm county participation and network for the plan year |
| Healthfirst | New York City metro and Long Island | Strong NYC-area networks; check hospital affiliations |
| EmblemHealth | New York City metro | Network and plan lineup vary by year |
| MetroPlusHealth | New York City (NYC Health + Hospitals plan) | NYC-only; tied to the public hospital system |
| Oscar | NYC metro and select counties | Virtual-care-forward plans; confirm county availability |
| Excellus BlueCross BlueShield | Much of upstate New York | Often the broadest upstate networks |
| MVP Health Care | Hudson Valley, Capital Region, and parts of upstate | Check county-level participation |
| CDPHP | Capital Region and nearby counties | Regional networks centered on Albany |
| Independent Health | Western New York | Buffalo-area focused networks |
| Highmark Blue Cross Blue Shield of WNY | Western New York | Confirm plan-year participation |
| UnitedHealthcare | Select counties | Participation varies; verify for your county |
Carrier participation in NY State of Health changes by county and plan year. This list reflects commonly seen carriers, not a guarantee of availability — confirm current participation before enrolling.
Local health insurance guidance across New York
Albany
Compare Albany and Capital Region health insurance via NY State of Health — CDPHP and MVP options, Albany Med and St. Peter's networks, subsidies, and timing.
Compare local plans →The Bronx
Compare Bronx health insurance on NY State of Health. See which plans include Montefiore, Jacobi, Lincoln, and BronxCare, plus Essential Plan and Medicaid options.
Compare local plans →Brooklyn
Compare Brooklyn health insurance through NY State of Health. Check plans against Maimonides, NYU Langone Brooklyn, and One Brooklyn Health, plus Essential Plan help.
Compare local plans →Buffalo
Compare Buffalo and Erie County health insurance on NY State of Health — Independent Health, Highmark BCBS of WNY, Kaleida and ECMC network guidance, and subsidies.
Compare local plans →Long Island
Compare Long Island health insurance for Nassau and Suffolk through NY State of Health — Northwell, NYU Langone, Catholic Health, and Stony Brook network guidance.
Compare local plans →Manhattan
Compare Manhattan health insurance on NY State of Health. See which plans reach NewYork-Presbyterian, Mount Sinai, and NYU Langone, plus Essential Plan options.
Compare local plans →New York City
Compare New York City health insurance through NY State of Health: NYC carriers, hospital networks from NYC Health + Hospitals to NYU Langone, and the Essential Plan.
Compare local plans →Queens
Compare Queens health insurance on NY State of Health. Match plans to Elmhurst, NewYork-Presbyterian Queens, Northwell, and Mount Sinai Queens networks and subsidies.
Compare local plans →Rochester
Compare Rochester and Monroe County health insurance on NY State of Health — Excellus BCBS and MVP options, URMC and Rochester Regional networks, and subsidy help.
Compare local plans →Staten Island
Compare Staten Island health insurance via NY State of Health. Check plan access to Staten Island University Hospital and RUMC, plus Essential Plan eligibility.
Compare local plans →Syracuse
Compare Syracuse and Onondaga County health insurance on NY State of Health — Excellus BCBS options, Upstate, Crouse, and St. Joseph's networks, and subsidy help.
Compare local plans →Westchester County
Compare Westchester County health insurance through NY State of Health — Westchester Medical Center, White Plains Hospital, and Northwell network checks plus subsidies.
Compare local plans →New York health insurance runs through NY State of Health, the state-based marketplace where individuals and families compare Qualified Health Plans, apply income-based financial help, and enroll. New York also layers on programs most states do not have — most notably the Essential Plan for moderate-income New Yorkers and Child Health Plus for kids — which can change the math for a household significantly.
How coverage works in New York
New York is a state-based marketplace (SBM) state. That means:
- Plan shopping, subsidy determination, and enrollment all happen through NY State of Health — not HealthCare.gov.
- Open enrollment dates are set by New York and have historically run longer than the federal window (typically mid-November through January 31 — verify the current year's dates before relying on them).
- Outside open enrollment, qualifying life events — losing employer coverage, moving, marriage, a birth — open a special enrollment period. Essential Plan and Medicaid enrollment is year-round for those who qualify.
New York is also a community-rating state for individual coverage: premiums are not varied by age or tobacco use the way they are in most states. That changes how plans compare for younger and older shoppers alike.
Programs worth knowing by name
| Program | Who it serves |
|---|---|
| Qualified Health Plans (QHPs) | Individuals and families buying bronze/silver/gold/platinum marketplace coverage, with APTC subsidies for eligible incomes |
| The Essential Plan | New Yorkers with moderate incomes (eligibility expanded in recent years) — low or no premium, low cost-sharing |
| Medicaid managed care | Lower-income households; year-round enrollment |
| Child Health Plus | Children's coverage regardless of immigration status, with sliding-scale premiums |
Carriers New Yorkers commonly compare
Carrier participation varies sharply by county — a plan dominant in Brooklyn may not exist in Buffalo. Names shoppers commonly see include Fidelis Care, Healthfirst, EmblemHealth, MetroPlusHealth (New York City), Oscar, UnitedHealthcare, Excellus BlueCross BlueShield (much of upstate), MVP Health Care, CDPHP (Capital Region), Independent Health and Highmark Blue Cross Blue Shield (Western New York). Always confirm current plan-year participation for your county before enrolling.
Local guidance, county by county
Networks, hospital systems, and carrier participation are local. Start with your area: New York City and its boroughs, Long Island, Westchester, Buffalo, Rochester, Albany, or Syracuse — each guide below covers the carriers, dominant health systems, and enrollment details that actually apply there.
What to prepare before comparing
- ZIP code and county where you need coverage
- Household size and an income estimate (drives subsidy and Essential Plan eligibility)
- Your doctors, hospitals, and prescription list
- Coverage start date you need and any qualifying life event
Availability, eligibility, pricing, and enrollment support depend on your county, household, plan year, and the licensed producer involved. Program rules change; verify details with NY State of Health. This guide is educational and is not legal, tax, or insurance advice.
Frequently asked questions
What is NY State of Health?+
NY State of Health is New York's official state-based health insurance marketplace. It is where individuals and families compare Qualified Health Plans, apply income-based financial help such as the Advance Premium Tax Credit, and enroll in coverage including the Essential Plan, Medicaid, and Child Health Plus.
What is the Essential Plan and who qualifies?+
The Essential Plan is New York's coverage program for moderate-income residents who earn too much for Medicaid. It features low or no monthly premium and low cost-sharing, and enrollment is year-round. Eligibility is income-based and has expanded in recent years — check current limits with NY State of Health.
When is open enrollment in New York?+
New York sets its own open enrollment window through NY State of Health, historically running from mid-November through January 31 — longer than the federal window. Verify the current plan year's exact dates before relying on them. Outside that window, qualifying life events open a special enrollment period.
Do health insurance prices in New York vary by age?+
No. New York uses community rating for individual coverage: premiums do not vary by age or tobacco use. That makes New York different from most states and changes how plans compare for younger and older shoppers.
Which insurance carriers offer plans in New York?+
Participation varies by county. Commonly seen carriers include Fidelis Care, Healthfirst, EmblemHealth, MetroPlusHealth (NYC), Oscar, Excellus BlueCross BlueShield (upstate), MVP Health Care, CDPHP, Independent Health, and Highmark BCBS of Western New York. Always confirm current plan-year participation for your county.
Can a broker help me with NY State of Health plans?+
Yes. Certified brokers can help you compare NY State of Health plans and complete enrollment at no added cost — plan prices are the same with or without broker help. Confirm the broker is certified with NY State of Health and licensed in New York.
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