Essential Plan

The Essential Plan is for New Yorkers who do not qualify for Medicaid or Child Health Plus, but still need access to high quality health care. Fidelis Care offers four different income-based "tiers" of the Essential Plan. 
 

Who can apply?

The Essential Plan is for individuals who meet certain income requirements. It's a good option for young adults who no longer qualify for Child Health Plus. It’s also great for people who can’t get health coverage through their employer. Open enrollment is available year-round.  If eligible, you can sign-up today!

Essential Plan Costs

Fidelis Care offers four types of Essential Plans: Essential Plan 1, 2, 3, and 4. Your income will determine which plan you are eligible for. 

Costs vary between tiers depending on your eligibility:

• Monthly premium is $0
• Office visits are $0 or $15 for a PCP, and $0 or $25 for a specialist.
• Inpatient hospital stays are $0 or $150. 
• There is no deductible for any of the plans.
• All plans offer in-network only coverage (except for emergency services which are covered at any provider). 
• Always check if your provider is in network before receiving care. Your costs will be higher if you receive care out of network.

How to Enroll in an Essential Plan

Once you know the health coverage you qualify for, there are four ways you can enroll:

• Call 1-888-FIDELIS (TTY: 711)

• Find a Fidelis Care office near you.
  Make an appointment, or visit during regular business hours!

• Enroll Online via NY State of Health. 
  Visit NYSOH and click on "Start Enrollment."

• Select 'Get Started' in the next box to contact a certified representative.