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HomeMemberManage Your PlanEssential PlanNew York Essential Plan Changes

Important Changes for Essential Plan 200-250 Members

Because of changes in federal rules, the Essential Plan 200-250 will end on June 30, 2026. If your household income is between 200% and 250% of the federal poverty level, you will be affected by this change. You should have received a letter from NY State of Health about this change.

What happens now?

You still have coverage until June 30, 2026. Continue to go to your doctor appointments and get your medications from your in-network pharmacy. Nothing about your insurance has changed until July 1, 2026.

What happens next?

NY State of Health will look for other programs you might qualify for, using the information you provided and data from federal and state sources. NY State of Health will send you another letter by May 15 – about 45 days before your Essential Plan 200-250 coverage ends – explaining what plan you qualify for. Depending on your information, you may qualify for other subsidized health coverage.

What do I need to do?

Review your NY State of Health account. Make sure your information, including income, household size, and where you live, are up to date. This helps NY State of Health find the best plan for you.

Can I join another Fidelis Care health plan?

Yes, you most likely will be able to apply for another health plan offered by Fidelis Care. NY State of Health will suggest a new plan based on your NY State of Health account information and data from federal and state sources. They will send that information to you by May 15. We recommend you wait until you receive that letter. If you have questions about Fidelis Care plans, including our Ambetter from Fidelis Care Qualified Health Plans, you can contact us.


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Fill out our contact form, and a Representative will call you.

We will be able to better help you after you receive your May 15 letter from NY State of Health about coverage options.

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Frequently asked questions

What if I’m pregnant or just had a baby?

If you are pregnant or your pregnancy ended in the last 12 months AND you are a U.S. citizen, U.S. national, or lawfully present:

  • If your baby is due within 6 months from July 1, 2026, or your pregnancy ended less than a year ago, you can keep your Essential Plan. No action needed unless your situation changes.
  • If your baby is due more than 6 months from July 1, 2026, your Essential Plan ends June 30, 2026. You'll be moved to Medicaid. No action needed unless your situation changes.

If you are pregnant or recently gave birth in the 12 months AND are NOT a U.S. citizen, U.S. national, or lawfully present:

  • Your Essential Plan ends June 30, 2026. You'll be moved to Medicaid. No action needed unless your situation changed.
How do I update my NY State of Health information?
  1. Sign in to your NY State of Health account at www.nystateofhealth.ny.gov.
  2. Click "Update Application."
  3. Click through the pages in the application and update details for your household.
  4. Review and submit your application.
What are Ambetter from Fidelis Care Qualified Health Plans?

Ambetter from Fidelis Care offers a variety of affordable Qualified Health Plans through the NY State of Health Marketplace. Our Ambetter plans have some of the lowest costs in New York State.

These plans include:

  • Emergency Care
  • Hospitalization
  • Laboratory Services
  • Maternity & Newborn Care
  • Outpatient or Ambulatory Care
  • Prescription Drugs
  • Preventive & Wellness Care

Plus, you get extra benefits like 24/7 Telemedicine Program with $0 Copay, Wellness Rewards, Ambetter Perks, and Fitness Reimbursement!

Can I keep my doctor?

Right now, you can continue to see the same doctors you have been seeing. Once your coverage ends on June 30, your provider network may be different depending on the coverage you move to. To check:

Our goal is to help you stay connected to care.

Will my costs go up?
Costs can vary depending on the coverage you qualify for next. New York State is reviewing ways to potentially help keep coverage affordable for members transitioning out of Essential Plan 200-250. Once there is more information from NY State, we can help you look at your options.
What if I’m a Deferred Action for Childhood Arrivals (DACA) enrollee?
Due to federal changes, you may no longer be eligible for Essential Plan programs. Depending on your income or on whether you are pregnant, you may be eligible for Medicaid.

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