About 26,000 people in the Rochester and Finger Lakes regions are affected by New York’s Essential Plan eligibility changes, according to Rochester Regional Health, which says its financial case managers are helping patients find other coverage.
The health system said in an Oct. 5 update that it is contacting patients identified as affected and offering help through its Help Me Apply program. Patients can also seek assistance rather than waiting to be contacted.
The change took effect July 1 after federal eligibility rules ended Essential Plan coverage for households with incomes between 200% and 250% of the federal poverty level. State officials said earlier this year that most affected people would qualify for other marketplace plans, although their premiums or out-of-pocket costs could be higher. Being affected by the eligibility change does not necessarily mean becoming uninsured.
How the health system is responding
Rochester Regional said New York Department of Health officials reviewed affected patients and automatically renewed as many as possible into alternative coverage. The department then shared information about remaining affected patients with the health system so its financial case managers could reach out.
Once connected with a patient, a case manager can help update an application and enroll the person in another plan. Patients may also update their applications and enroll on their own. Financial case managers try to visit affected patients who are already in a Rochester Regional hospital or office; when an in-person visit is not possible, they follow up by telephone or a MyCare message.
Amy Armstrong-Szabo, Rochester Regional’s director of financial counseling, said several of the system’s hospitals are seeing more patients pay out of pocket for care than during the same period last year. The health system did not provide a hospital-by-hospital count or attribute that entire increase to the Essential Plan change.
Where patients can get help
Patients who need help finding coverage or financial assistance can contact Rochester Regional’s Help Me Apply team at 585-922-1900 or [HelpMeApply@rochesterregional.org](mailto:HelpMeApply@rochesterregional.org). The service is available to people who need help applying for health insurance, not only those affected by the Essential Plan change.
The health system said it continues to work with state representatives on the impact of the coverage change and offers other financial-assistance options depending on eligibility. New York residents can also review current insurance choices through NY State of Health.
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