These days, there's one question I hear the most: "How do I go to the hospital without insurance?" This question has increased significantly since this summer.

There's a reason for this. Starting July 1, 2026, the federal poverty level income range of 200-250% was removed from New York's Essential Plan. This is due to the federal law H.R. 1 passed in July 2025.

Because of this law, many legal immigrants have been excluded from premium tax credits, and DACA recipients will see their coverage end or change. Local reports indicate that about 450,000 New York residents lost their Essential Plan on July 1.

Honestly, I was a bit stunned by this number. In this situation, NYC Care is gaining renewed attention.

First, let me clear up a misunderstanding. NYC Care is not insurance. It is a "healthcare access program" operated by NYC Health + Hospitals, the public hospital system in New York City.

In simple terms, instead of receiving an insurance card, you get a membership card, allowing you to receive care at city public hospitals and clinics at low or no cost. There are no monthly premiums or enrollment fees.

So, who can enroll? The requirements are simpler than you might think. You must live within the five boroughs of New York City.

Additionally, you must not qualify for any health insurance available in New York State or be unable to afford insurance according to government standards. These are the two key points.

The most important point is that they do not ask about your immigration status. You do not need a Social Security number, a green card, or immigration documents.

The official FAQ clearly states that they do not record immigration status information. In today's climate, this reassurance is quite significant.

Previously, there was a requirement to have lived in New York City for at least six months. However, as of April 20, 2022, this residency requirement has been removed.

So now, even someone who just moved can qualify as long as they can prove an address within the five boroughs. This is a real big deal for new immigrants.

The cost is determined on a sliding scale based on household size and income. It starts at $0, and your fee is indicated on your membership card.

This means you have less anxiety about "How much will this cost?" before going to the hospital, as you can see your fee range on the card.

The services available are surprisingly broad. They include primary care, preventive care, and referrals to specialists when needed. Mental health services and affordable medication costs are also included.

New members are promised a primary care appointment within two weeks. There is also a 24-hour customer service center.

Recently, they have started providing affordable or free medical equipment (DME) like wheelchairs and walking aids. I just learned about this while researching.

It's not a small program either. It started in the Bronx in August 2019 and expanded to Brooklyn and Staten Island in January 2020, and then to Manhattan and Queens in September of the same year.

By February 2024, membership exceeded 125,000, and as of July this year, there were over 130,000 active members, with more than 1 million primary care appointments made.

However, there are some limitations to be aware of. NYC Care can only be used within the NYC Health + Hospitals system. This includes a network of 11 hospitals and community health centers.

This card does not work at local private clinics or other private hospitals. It's important to understand that it is not like insurance that can be used anywhere.

Enrollment starts with a phone call. You can call 646-NYC-CARE, which is 646-692-2273. They provide consultations in multiple languages, and this year's promotional campaign included Korean.

It's a good idea to have proof of address and documents showing your income ready before you call. There is a re-evaluation every year, so keep the documents you submitted initially.

You can renew your card starting 30 days before it expires, so I recommend setting a reminder on your calendar. Missing this can lead to unnecessary hassle.

One more thing: just because someone is dropped from the Essential Plan doesn't mean they automatically qualify for NYC Care. Depending on their income, the NY State of Health marketplace plan or employer insurance might be a better fit.

So, I think the order of checking is important. First, check insurance eligibility, and if that doesn't work out, then look into NYC Care. Ultimately, what treatment or medication is right for you should be decided in consultation with a doctor or pharmacist.

Personally, I feel fortunate that such a program exists. It's natural to go to the hospital when you're sick, but many people hold back due to their status or bank balance.

If you know anyone struggling without insurance, please make sure to share this number with them. The difference between knowing and not knowing is greater than you might think.