Vivinavi : New Jersey : (United States) New Jersey

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New York State Department of Health （ NY State of Health: NYSOH ） Changes to Health Insurance Eligibility Rules

Due to funding cuts resulting from federal policy changes, NY State of Health (NYSOH) is revising the eligibility rules for health insurance enrollment for individuals under the age of 65.

1. Changes to the Essential Plan (EP) ：

The EP200-250 plans, which had no monthly premiums, ended at the end of June 2026. EP200-250 enrollees who wish to continue their coverage can transition to a Qualified Health Plan (QHP), which requires monthly premiums.

If you are enrolled in EP200-250 and have not yet completed the process to switch to a QHP, please do so as soon as possible, as August 30 marks the end of the Special Enrollment Period. After this period ends, you will not be able to enroll until the next Open Enrollment period （ November 16 ～ ）, and you will be uninsured until January of next year.

＊ If you would like JASSI to assist you with enrollment, please contact us by Friday, August 28 （ ）. Please note that we tend to be very busy as the deadline approaches, so we ask that you contact us as soon as possible.

For those who were enrolled in EP200-250 and and are expecting to give birth by December 31, 2026 ： will be eligible for Essential Plan 1 （ EP1 ） during pregnancy and childbirth.

If you were enrolled in EP200-250 and are expecting to give birth on or after January 1, 2027 ： NYSOH will send you information about insurance plans available to you after your EP200-250 coverage ends. Please follow the instructions in the notice to complete the necessary procedures.


2. Changes to Medicaid Eligibility （ Effective July 1, 2026 ） ： ① Medicaid enrollees aged 19 or older and under 65 （ Excluding pregnant women and those 18 years of age or younger ）

Previously, once you enrolled in Medicaid, you could generally remain enrolled for one year even if your income increased during that time; however, but starting in July 2026, if you no longer meet the eligibility requirements—such as if your income exceeds the eligibility threshold—you may lose your Medicaid eligibility without having to wait for your renewal date.


② Renewal Procedures for Children Under Age 6

Previously, Medicaid and Child Health Plus coverage for children under age 6 was automatically renewed, but beginning in July 2026, an annual renewal process will be required.


3. Eligibility Requirements for Continuing Medicaid （ Effective January 1, 2027 ） ：

To continue Medicaid, you must meet one of the following criteria: ① – ③. （ For individuals aged 19 or older but under 65 ： Excluding pregnant women and those 18 years of age or younger. ）


① Have a monthly income of at least $580 （ * Based on the federal minimum wage ）

② Work at least 80 hours per month, meet one of the following conditions ：

＊ Currently employed

＊ Student （ Full- or part-time ）

＊ Participating in vocational training or employment support programs

＊ Participating in volunteer or community activities

③ Meets the criteria based on a combination of income and time spent on activities ：

For example, if a person has a monthly income of $380, that income is converted to the equivalent of approximately 52 hours. If you spend the remaining 28 hours on work ・, attending school ・, vocational training ・, volunteer activities, etc., the total will be 80 hours, allowing you to meet the requirements.

New applicants for Medicaid or those seeking renewal will be asked to confirm whether they met any of the above conditions—or a combination thereof—during the most recent one-month period prior to applying. Details regarding Medicaid continuation requirements are scheduled to be announced around November 2026.


Regarding the Renewal Process

If you need to renew your current health insurance or verify your eligibility, you will receive a notification letter from NYSOH at least one month in advance. Please be sure to review the notification letter and submit the required documents to NYSOH. Please note that if you are late in submitting the documents or do not meet the renewal requirements, your health insurance coverage may be terminated.


If you have any questions or concerns, please contact JASSI.

Email: Info@jassi.org

Phone: 212-442-1541, ext. 1

Reference Website
https:// info.nystateofhealth.ny.gov/sites/default/files/Changes-to-Medicaid-Coverage-Fact-Sheet-English.pdf
https://info.nystateofhealth.ny.gov/stay-covered