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  • How will I receive my insurance card and how long will it take?
    Generally the insurance card will arrive to your MAILBOX in about 10 business days.
  • How can I enroll in Essential Plan?
    You can submit the application document by filling out the form on our website and submitting the related documents.
  • Who is eligible for Essential Plan?
    Adult who is 19 - 64 years of age. Is a New York State resident. Meet income eligibility requirements. (Examples: single adults earning up to $27,180) Are U.S. citizens or meet immigration status/visa requirements.
  • What is the income guideline for Essential Plan?
    According public information, NY State set the income guideline as follows: For single person: Essential Plan 1 - Individuals with annual income greater than $20,385 and less than or equal to $27,180. Essential Plan 2 - Individuals with income greater than $18,755 and less than or equal to $20,385. Essential Plan 3 - Individuals with income equal to or greater than $13,590 and less than or equal to $18,755, and not eligible for Medicaid due to immigration status. Essential Plan 4 - Individuals with income below $13,590, and not eligible for Medicaid due to immigration status. If you need information about income guideline for a family of more than 1 person, please contact us.
  • When can I enroll in Essential Plan?
    Enrollment for the Essential Plan is open all year long.
  • Will the essential plan cover pregnancy and maternity?
    Yes, it covers family planning and OB check up. However, the New York State of Health requires that you report your pregnancy when you found you're pregnant. And then, the system will turn your essential plan into Medicaid.
  • Can I waive my school insurance with the Essential Plan?
    Depends on which school you are enrolling in. Your school health center can make final decision, please check their website to see if the Essential Plan meets the school waiver requirement
  • What is the process to waive my school insurance with the Essential Plan?
    The waiver process varies and depends on the school. We will assist you in the process after you enroll in Essential Plan.
  • I already have Essential Plan, can you still help me?
    Yes, if you got essential plan, we can still help you if you agree, we can contact NY State of Health to change your Insurance representative.
  • What service do the Essential Plans cover?
    Here is a list of the 10 essential health benefits and what they mean. Prescription Drugs The federal government has categorized approved prescription drugs. One from each category must be covered. Pediatric Services This includes dental care, vision care, well-child visits, vaccinations, and immunizations. Dental and vision care must be offered to children through the age of 19 (pediatric oral health services can include two routine dental exams per year; ocular care can include one annual eye exam). Preventive and Wellness Services and Chronic Disease Management This includes services such as diet counseling, colorectal cancer screening, Type 2 diabetes screenings, and immunization vaccines. Emergency Services This is a trip to the emergency room where you truly need care as soon as possible. It means that you won’t be penalized if the hospital is out of network. Hospitalization Treatment you receive in the hospital as part of inpatient care. Plans may limit coverage for extended stay. Mental Health and Addiction Services This includes services to treat behavioral health, provide counseling, or provide psychotherapy. Pregnancy, Maternity, and Newborn Care These are services that care for you and your baby before, during, and shortly after giving birth. Ambulatory Patient Services This is outpatient care you receive without being admitted to the hospital. Laboratory Services This includes testing to diagnose, to gauge effectiveness, and some preventive screenings. Rehabilitative and Habilitative Services and Devices These services help you recover if you are injured, have a disability, or have a chronic condition. Services may include physical therapy, occupational therapy, or speech therapy.
  • Does Essential Plan affect my immigration/visa status (OPT, H1B and then Green card application)?
    No. Enrolling in the Essential Plan will not affect your immigration status as this is a state funding instead of a federal benefit. Further more, the public charge rule is no longer in effect according to USCIS.
  • Can my plan be terminated?
    Yes, you can voluntarily terminate it, or if your circumstance changed and you will be involuntarily ineligible: - If you fail the income guideline - Immigration status expired - move out of New York State your Essential Plan might be terminated.
  • I'm in OPT status. Am I eligible for the Essential Plan?
    OPT visa holder and also meets the following requirements are eligible for Essential Plan: 1. live in NY State 2. meet Essential Plan income guideline 3. over 21 years old 4.not eligible for group insurance
  • Does Essential Plan cover out-of-state visit medical service?
    No. Essential Plan network are within NY State. When you are out of NY State, you are only covered for emergency and urgent care.
  • Why Essential Plans premium are $0?
    The Essential Plans are funded by NY State of Health to help qualified applicants get health insurance.
  • Essential Plan的收入要求是什么?
    根据纽约州公开信息,收入要求如下: 对于单身人士: Essential Plan 1 - $20,385<年收入<= $27,180. Essential Plan 2 - $18,755 <年收入<= $20,385. Essential Plan 3 - $13,590 <年收入<= $18,755, 并且不符合medicaid Essential Plan 4 - 年收入 <= $13,590, 并且不符合medicaid 如果你需要了解非单身人士的收入要求,请联系我们。
  • 有已经办理了Essential Plan, 还可以找你帮忙吗?
    当然可以。我们依然可以帮你,如果你已经有了essential plan,我们可以联系纽约州卫生局,更换把你的保险代表,这样我们后续就可以协助你了。我们有多年的丰富的医保经验,不是市面上靠水军宣传起来的新公司可以对比的,希望你选择资深的经纪人。
  • 符合什么条件才可以参加Essential Plan
    -年龄在19至64岁之间的成年人(非移民必须年满21岁)。 -纽约州居民。 -能够满足基本计划的收入要求。(比如: 单身年收入不超过$27,180) -是美国公民或者有移民身份/签证。
  • 如何办理Essential Plan?
    您可以通过我们的网站提交申请表,填写表格并上传相关文件。
  • Essential Plan 会承保怀孕吗?
    会,会包产检 但是纽约州政府规定所有怀孕,要申报,一旦申报以后,保险会转为Medicaid 。
  • 我该如何申请替换学校的保险?
    替换流程取决于学校。办理完基本计划以后,我们会全程协助你替换学校保险。
  • 我可以用Essential Plan来免掉学校的保险吗?
    取决于您的学校。学校的health center有最终决定权,您可以在官网查询,或者咨询我们,我们有帮助过很多学校的学生成功替换学校的保险。
  • 我如何获取保险卡以及多久可以拿到保险卡?
    从批准日起,保险卡一般情况下会在10个工作日左右邮寄到你的信箱。
  • 基本计划是否包含州外的医疗服务
    不包。基本计划的医疗网络仅限于纽约州。当您在最州外的时候,您只能获得紧急情况和紧急护理的福利。
  • 什么时候可以参加基本计划?
    基本计划保险全年开放注册,一年十二个月都可以提交申请。
  • 我目前是OPT身份,是否符合Essential Plan 申请要求?
    OPT身份同时符合以下条件者可以加入Essential Plan: 1. 纽约州居民 2. 符合Essential Plan收入标准 3. 21岁以上 4.不符合公司保险
  • 我的Essential Plan会被终止吗?
    是的,你可以主动取消基本计划保险,或者如果你的情况改变也会导致你不符合基本计划的资格,比如: 如果收入超过了Essential Plan的收入要求 签证过期没更新 或从纽约州搬出 您的Essential Plan将会终止。
  • 为什么基本计划的月费是$0?
    基本计划是纽约州政府资助的保险,因此符合条件的申请人可以获得保费为$0的保险。
  • 加入Essential Plan会影响我的签证或身份吗(OPT, H1-B, 绿卡申请)
    不会影响。 Essential Plan不是联邦福利。 而且移民局已经不再采用公众负担这个规则。
  • 基本计划涵盖哪些医疗福利?
    日常门诊服务 Ambulatory Patient Services 此福利的保障范围包括了医生诊所丶当日手术中心丶独立的诊断图像中心和病理化验机构丶还有医院的门诊部。 急诊 Emergency Services 急诊室是为了拯救有死亡或伤残风险的病患而设立,基本计划提供急诊救护的保障,无须预先获得授权,使用救护车或医疗网外的急诊室也不会被收取额外费用。 住院 Hospitalization 此项福利涵盖了住院期间的看护丶诊疗丶手术丶检验等费用. 心理健康和药物滥用治疗 Mental Health and Substance Abuse Service 处方药 Prescription Drugs 虽然不是每一种药都包含在健康保险的给付范围之内,但是在联邦批准的每一范畴和种类的药物中,所有保险计划都必须包括至少其中一项药物,包括价格特别高的特种药,而且药品费用也会被计算入年度最高自费金额的上限中。 复健服务和设备 Rehabilitative and Habilitative Services and Devices 化验室检查 Laboratory Services 预防性护理服务 Wellness services and Chronic Disease Management 也就是说,从预防性治疗(比如打疫苗)到小病(感冒,发烧)再到大病(要叫救护车,或者手术抢救)都包了,而且自付额是$0
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