ExchangeCoverageMedium impact
Announcing Essential Plan 200–250
Healthfirst·NY·Provider Update
Effective date
Apr 1, 2024
We identified it
Jun 20, 2026
Summary
Healthfirst is launching a new Essential Plan 200-250 on April 1, 2024, expanding eligibility for individuals earning 200-250% of Federal Poverty Level with $0 premiums and extended postpartum coverage to 12 months. New member ID cards will show specific copay amounts including $15 PCP visits, $25 specialist visits, and $2,000 maximum out-of-pocket costs.
Action Required
By April 1, 2024: Billing team must update systems to recognize new Essential Plan 200-250 member ID cards and verify copay amounts ($15 PCP, $25 specialist, $25 urgent care, $75 ER, $150 inpatient, $6/$15/$30 prescriptions). Update patient registration to collect new ID cards and verify $0 deductible/$2,000 MOOP. Train front desk staff on expanded postpartum coverage now lasting 12 months instead of 60 days.