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Essential Plan

Offered by Independent Health to residents of Erie & Niagara Counties

What is Essential Plan?

The Essential Plan is a program for eligible New Yorkers with lower incomes. Independent Health offers the Essential Plan in Erie and Niagara counties.

There are four Essential Plan programs, eligibility for each is dependent on your family’s household income. Your out of pocket costs may be $0, $200 or a maximum $2,000 per plan year.

For additional information, make sure to check out some of our Helpful Resources.

Are you eligible?

To be eligible for Essential Plan you must meet ALL the requirements below:

You meet certain income requirements (varies per Essential Plan)

You are a resident of New York State

You are a U.S. citizen or fall within the Aliessa immigration status

You do not qualify for Medicare or Medicaid

You are age 19 – 64

You should apply for health insurance through the NY State of Health Marketplace at www.nystateofhealth.ny.gov or call 1-855-355-5777. (TTY: 1-800-662-1220) Monday-Friday, 8 a.m.-8 p.m. Saturday, 9 a.m.-1 p.m.

Need to Renew?

We Make It Easy! Call Now to Renew.

This year, New York State will require you to renew your health plan. The last thing you need to worry about is losing your coverage. It's time for you to renew. Let us help!

Why Choose Independent Health?

As a member with Independent Health you get personalized service and the attention you deserve. Plus, Independent Health offers you benefits, including: 

  • A wide provider network, offering you plenty of choices and access to doctors.
  • Help searching for a doctor, with access to our online Find a Doctor tool.
  • Online member tools, where you can check your benefit summary, review claims and more.
  • Wellness discounts at a wide range of community partners. Just show your member ID card!
  • 24-Hour Medical Help Line lets you speak with a registered nurse anytime you have a health concern or can’t reach your doctor!

Find a RedShirt

Select a convenient time at a location in your neighborhood to talk to a RedShirt about which plan option is right for you.

Plan Summary

Premium:


$0

Copayments:

The share you pay for each health service – your co-payments are also very low, sometimes as low as $0.*

Benefits at a Glance

Doctor Visits (Well or Sick) including specialists

Dental Care managed by Liberty Dental

Vision Care managed by Eyemed

Prescriptions
(copayments may apply)

Immunizations

Lab Tests and X-rays

Emergency/Urgent services

Inpatient or outpatient care at a hospital

Occupational, physical and speech therapy

Maternity Care

Family planning and reproductive services, including HIV testing

Behavioral Health Services managed by Carelon Behavioral Health

Orthotics/Orthopedic footwear

*Essential Plans 3 & 4 Only

Medicaid transportation, if needed (Common Benefits card)

*Essential Plans 3 & 4 Only

For a complete description of benefits please see the Essential Plan Schedule of Benefits or review your specific member contract in Helpful Resources

Benefit only available with Independent Health

Brook & Brook+

Personalized Health Support with Brook and Brook+, including Meal Planning and Nutrition Advice.**

Learn More

Helpful Resources

 

Summary of Benefits:

Contracts:

 

To learn more about applying for health insurance through NY State of Health, the Official Health Plan Marketplace, visit www.nystateofhealth.ny.gov or call 1-855-355-5777.

* Depending on the Essential Plan program you qualify for.
** Brook+ is available to eligible Independent Health members based on an eligibility survey. One fitness tracker voucher will be provided per eligible member after 4 weeks of program participation.