Is there help to pay for another insurance plan?
Possibly. Keep your information up to date with NY State of Health (NYSOH). They will review your information and determine if you are eligible for financial assistance in connection with a medical plan. NYSOH will have their Advanced Premium Tax Credit (APTC) calculator on their website beginning May 1, 2026. They will update you on your eligibility 45 days before your coverage ends.
I’m pregnant/I recently had a baby. Will I be able to stay covered during my pregnancy and postpartum period?
Yes. If you are pregnant or your pregnancy ended within the last 12 months and you are a U.S. citizen, U.S. national, or lawfully present, you will continue to have coverage.
- If your baby is due within six months of July 1, 2026, or your pregnancy ended less than a year ago, you will automatically be moved to the Essential Plan 1 variant and you will be covered under Essential Plan 1 until your postpartum period ends. No action is needed.
- If your baby is due more than six months after July 1, 2026, your Essential Plan coverage ends on June 30, 2026, and you’ll automatically be moved to Medicaid. No action is needed.
What happens to my over-the-counter (OTC) credit once I’m not an Essential Plan member?
Unfortunately, you will lose your OTC credit when your Essential Plan coverage ends. Please use your OTC credits before June 30, 2026. If you want more information on how to use your credits, visit emblemhealth.com/essentialplanotc.
What if I have a medical emergency while I am uninsured?
If you go to the hospital for a medical emergency while you are uninsured, you can apply for Emergency Medicaid. A hospital social worker can help you with NY State of Health paperwork.
My child is covered under Child Health Plus/my child is a Medicaid minor. Will my child lose coverage?
No, this change only affects members in Essential Plan 200-250. Your child’s coverage is not affected.
