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Am I eligible?

Eligibility can be hard to understand, but we’re here to help. There are many categories of eligibility for the different managed care programs we support. Call us at 1-888-809-8009 (TTY 711) or visit a local Community Service Center to get free, in-person help.

Didn’t find what you’re looking for? Check out our Individual and Family ACA plans.

Medicaid

Child Health Plus (CHPlus)

Essential Plan

Who’s eligible?

Children, adults and pregnant women who:

  • Live in Brooklyn, the Bronx, Queens, Manhattan, Staten Island, Nassau or Putnam County
  • Meet certain income, resource, age or disability requirements
Find out more about these requirements

Children under age 19 who:

  • Live in Brooklyn, the Bronx, Queens, Manhattan, Nassau, Putnam, Staten Island, Suffolk, or Westchester County
  • Are not eligible for Medicaid
  • Have little or no other health insurance coverage

Adults between the ages of 19 and 64 who:

  • Live in Brooklyn, the Bronx, Queens, Manhattan, Staten Island, Nassau or Putnam County
  • Are not eligible for Medicaid or Child Health Plus
  • Are not eligible for minimum essential coverage
What are the benefits?
  • Medical care like doctor visits and checkups, emergency and urgent care
  • Dental care
  • Vision care
  • Prescription drugs
  • Behavioral health services
  • Medical care like doctor visits and checkups, emergency and urgent care
  • Dental care
  • Vision care
  • Prescription drugs
  • Behavioral health services
  • Medical care like doctor visits and checkups, emergency and urgent care
  • Dental care (in select plans)
  • Vision care (in select plans)
  • Prescription drugs
  • Behavioral health services
View all benefits
View all benefits
View all benefits

MLTC, MAP and HARP eligibility

Managed Long-Term Care (MLTC and MAP) members

For adults age 18 or older who:

  • Live in Brooklyn, the Bronx, Manhattan, Queens or Staten Island
  • Are eligible for Medicaid
  • Have a chronic illness or disability that makes you clinically eligible for enrollment, based on an assessment

MLTC and MAP benefits

You get all of your current Medicaid benefits, plus long-term services and supports to help you stay in your home or community.

View MLTC benefits
View MAP benefits

Health and Recovery Plan (HARP)

For adults age 21 or older who:

  • Live in Brooklyn, the Bronx, Queens, Manhattan, Staten Island, Nassau or Putnam County
  • Are enrolled in Medicaid
  • Have been diagnosed with serious mental illness or substance use disorder
  • Meet criteria and risk factors determined by the state of New York

HARP benefits

You get all of your current Medicaid benefits, plus:

  • Help with getting or keeping a job
  • Housing help
  • Independent living advice
View all benefits

Found the Empire plan for you? Learn how to enroll with us.

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