Important Changes to Plan Coverage

Due to changes in federal rules, Essential Plan coverage for members with household income between 200% and 250% of the federal poverty level will end June 30, 2026. NY State of Health has reviewed eligibility for affected members and mailed notices that explain current health plan eligibility and next steps.

What is changing?

Essential Plan coverage for members with income between 200% and 250% of the federal poverty level is ending June 30, 2026. If you have an Essential Plan and your household income is in this range, you can continue to use your plan until your coverage ends.

What happens next?

NY State of Health reviews health coverage eligibility using information such as household size, income, citizenship status, and other federal and state data sources. You should have received a notice from NY State of Health that explains what health coverage you may qualify for starting July 1, 2026.

What do I need to do?

Review your NY State of Health account and make sure your information is up to date, including your income, household size, and address. If you are no longer eligible for the Essential Plan or Medicaid, you may need to choose a new plan to avoid a gap in coverage after June 30.

What are my coverage options?

Many members may be eligible for other health plans offered by MVP, including Qualified Health Plans. Coverage options are based on your NY State of Health account information, as well as other federal and state sources.

How can MVP help?

MVP representatives are available to answer your questions and help you explore your options. Call us at 1-833-825-8891 (TTY 711), Monday–Friday, 8 am–6 pm.

FAQs

Can I stay with MVP?

Yes. Many members will be able to transition to another health plan offered by MVP.
When will I hear from NY State of Health?

NY State of Health has sent notices explaining eligibility and coverage options for members impacted by this change. Review your notice carefully, as it explains what coverage you qualify for next.
Do I need to change plans right now?

You don’t need to enroll in a new plan today. You should have received a letter from NY State of Health that explains your health plan eligibility and coverage options. We recommend reviewing that notice and connecting with an MVP representative if you have questions or need help understanding next steps.
Will my costs increase?

Costs can vary depending on the coverage you qualify for next. MVP is here to help you find a plan that fits your health needs and budget.
What are Qualified Health Plans?

Qualified Health Plans (QHPs) are health plans for individuals and families who live in New York State. If you are no longer eligible for the Essential Plan, a QHP may be an option for continued coverage.

You can enroll in a QHP through MVP by shopping for an individual or family plan. You can also enroll through NY State of Health, the Official Health Plan Marketplace. Enrolling through NY State of Health is the only way eligible consumers can receive financial assistance to help reduce premium costs.

These plans include individual and family coverage with access to thousands of doctors, $0 preventive care, and virtual visits. Subsidies are available for those who qualify.

Plus, these plans offer a $600 well-being reimbursement, 24/7 Gia® virtual care services, and access to Health Savings Accounts.

Want to see what coverage options may be available to you?

Explore Individual and Family plans though MVP, or get help understanding your options by calling 1-833-825-8891 (TTY 711).

To learn more about applying for health insurance including Medicaid, Child Health Plus, Essential Plan, and Qualified Health Plans through NY State of Health, The Official Health Plan Marketplace, visit www.nystateofhealth.ny.gov or call 1-855-355-5777.

ATTENTION: Language assistance services and other aids, free of charge, are available to you. Call 1-800-825-7826 (TTY 711).

ATENCIÓN: Dispone de servicios de asistencia lingüística y otras ayudas, gratis. Llame al 1-800-825-7826 (TTY 711).

请注意：您可以免费获得语言协助服务和其他辅助服务。请致电 1-800-825-7826 (TTY 711).

Health benefit plans are issued or administered by MVP Health Plan, Inc.; MVP Health Insurance Company; MVP Select Care, Inc.; and MVP Health Services Corp., operating subsidiaries of MVP Health Care, Inc. Not all plans available in all states and counties.