The Essential Plan

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Plans with access to essential health benefits like doctor visits, lab tests, prescription drugs, hospitalization, urgent care, emergency care, vision, dental, and more—all for a $0 monthly plan premium. These plans are for qualified individuals ages 19–64.

Plan Highlights:

  • No-cost annual checkups
  • Hospital, emergency room and urgent care visits
  • Lab tests and X-rays
  • Prescription drug coverage
  • Maternity and newborn coverage
  • No-cost dental and vision coverage*
  • 24/7 access to care with telemedicine (Teladoc)**
  • Physical, occupational, and speech therapy
  • Annual gym membership reimbursement†
  • 2021
Tier
Essential Plan 1
Essential Plan 1 Plus Dental & Vision
Summary of Benefits and Coverage (PDF)
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English
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Español 中文
Premium
$0
Eligible Age
19 to 64
Eligible Service Areas
Within New York City's five boroughs (the Bronx, Brooklyn, Manhattan, Queens, and Staten Island), Long Island, and Westchester, Orange, Rockland, and Sullivan counties
Other Eligibility Requirements
Income between $19,320 and $25,760††
Dental Cleanings
$0 copay
$0 copay
Vision Exams
$0 copay
$0 copay
Telemedicine (Teladoc)
$0 copay
$0 copay
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Tier
Essential Plan 2
Essential Plan 2 Plus Dental & Vision
Summary of Benefits and Coverage (PDF)
English
More Languages
Español 中文
English
More Languages
Español 中文
Premium
$0
Eligible Age
19 to 64
Eligible Service Areas
Within New York City's five boroughs (the Bronx, Brooklyn, Manhattan, Queens, and Staten Island), Long Island, and Westchester, Orange, Rockland, and Sullivan counties
Other Eligibility Requirements
Income between $17,774 and $19,320††
Dental Cleanings
$0 copay
$0 copay
Vision Exams
$0 copay
$0 copay
Telemedicine (Teladoc)
$0 copay
$0 copay
More Plan Information More plan information dropdown arrow
Tier
Essential Plan 3
Summary of Benefits and Coverage (PDF)
English
More Languages
Español 中文
Premium
$0
Eligible Age
21 to 64
Eligible Service Areas
Within New York City's five boroughs (the Bronx, Brooklyn, Manhattan, Queens, and Staten Island), Long Island, and Westchester, Orange, Rockland, and Sullivan counties
Other Eligibility Requirements
Income between $12,880 and $17,774††
Requires legal U.S. residency for less than five years. Learn more about your legal status here.
Dental Cleanings
$0 copay
Vision Exams
$0 copay
Telemedicine (Teladoc)
$0 copay
More Plan Information More plan information dropdown arrow
Tier
Essential Plan 4
Summary of Benefits and Coverage (PDF)
English
More Languages
Español 中文
Premium
$0
Eligible Age
21 to 64
Eligible Service Areas
Within New York City's five boroughs (the Bronx, Brooklyn, Manhattan, Queens, and Staten Island), Long Island, and Westchester, Orange, Rockland, and Sullivan counties
Other Eligibility Requirements
Income less than $12,880††
Requires legal U.S. residency for less than five years. Learn more about your legal status here.
Dental Cleanings
$0 copay
Vision Exams
$0 copay
Telemedicine (Teladoc)
$0 copay
More Plan Information More plan information dropdown arrow

Note: Due to a changes in New York State regulation, as of June 1, 2021:
• Essential Plan 1 and Essential Plan 1 Plus Dental & Vision cost-sharing and benefits are the same.
• Essential Plan 2 and Essential Plan 2 Plus Dental & Vision cost-sharing and benefits are the same.

*Dental services must be medically necessary to be covered; limitations apply.

**Telemedicine isn’t a replacement for your Primary Care Provider (PCP). Your PCP should always be your first choice for care (both in-person and virtual visits).

†Up to $200 per reward period. There are two reward periods—January through June, and July through December.

††Based on 2020 earnings. The income ranges shown are for individuals only. The income ranges may increase based on the eligible members in your household. To learn more, talk to a Healthfirst representative.

The benefit information provided is a brief summary, not a complete description, of benefits. For more information, contact the plan.

Coverage is provided by Healthfirst PHSP, Inc. Plans contain exclusions and limitations.

Additional Benefits

  • Additional benefit image

    24/7 Access to Telemedicine with Teladoc*

    Talk to a doctor any time—for a $0 copay. Connect with board-certified doctors through video chat or phone for prescriptions, help diagnosing and treating non-emergency conditions, and more. Access to dermatologists is also available.

    *Telemedicine isn’t a replacement for your Primary Care Provider (PCP). Your PCP should always be your first choice for care (both in-person and virtual visits).

  • Additional benefit image

    Urgent Care Center Network

    Get the care you need when you need it at an urgent care center in our network—no appointment needed. Urgent care centers offer late-night and weekend hours, often with faster service at a lower cost than the Emergency Room (ER).

    Visit an in-network urgent care center to get help for non-emergency conditions like earache, upset stomach, sprains, stitches, and more.

  • Additional benefit image

    Active & Fit Direct

    Working out just got easier. For just $25/month plus a one-time enrollment fee of $25, you can get a standard membership to a fitness center in your area. Track your activity, check your progress, reach your fitness goals, and so much more!

    Please note: a three-month membership commitment is required up front. Learn more about Active & Fit Direct.

  • Additional benefit image

    Rewards for Working Out

    You can get rewarded for taking care of your health—up to $400 in a calendar year with the ExerciseRewards™ program**.

    It’s easy! Work out at a qualifying gym or fitness facility at least 50 times in a six-month period and track your workouts.

    Learn more about ExerciseRewards™ or
    start earning your reward now!

    **Up to $200 per reward period. There are two reward periods—January through June, and July through December.

Additional Benefits

  • 24/7 Access to Telemedicine with Teladoc*

    Additional benefits dropdown arrow

  • Urgent Care Center Network

    Additional benefits dropdown arrow

  • Active & Fit Direct

    Additional benefits dropdown arrow

  • Rewards for Working Out

    Additional benefits dropdown arrow

Frequently Asked
Questions

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Support When You Need It

We're happy to answer your questions.

Learn about enrollment

1-844-488-1486

Monday to Saturday, 8am–8pm

TTY English: 1-888-542-3821

TTY Español: 1-888-867-4132

Member Services

1-888-250-2220

Monday to Friday, 8am—8pm

TTY English: 1-888-542-3821

TTY Español: 1-888-867-4132

Can't talk right now?

Request a callback and we’ll get back to you within one business day.

You can also visit our Virtual Community Office to connect with a local Healthfirst representative or to find a community office near you.

You can also go to the NY State of Health’s website to view your choices, or call the NY State of Health customer service center at 1-855-355-5777.

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