CurrentEmblemHealthPolicy N/A

Essential Plan immigration documentation list

Lists immigration and identity documents New York State's official marketplace may require Essential Plan members to provide to maintain eligibility and coverage; affects Essential Plan members in New York State.

Policy Summary

PayerEmblemHealth

PolicyEssential Plan immigration documentation list

Policy CodePolicy N/A

Change TypeNo material changes

Effective DateN/A

Next Review DateN/A

Key ActionMembers must provide required immigration/identity documents within allowed timeframes or risk losing coverage; assistance available via phone 877-444-7330 (TTY: 711).

SourceLink

POLICY UPDATE CHANGES

No material clinical or coverage changes in this revision.

~30+document types/examples

1 phonemember assistance

NYjurisdiction

Essential Planprogram

Documentation Submission Requirement

Document submission requirement

Documentation requirement and consequence

Member must submit required immigration or identity documentation as requested by New York State's official health plan marketplace to maintain Essential Plan eligibility and coverage.

If the member does not provide the required documentation within the allowed timeframe, the member may lose coverage or eligibility.

Assistance is available to members who need help submitting documents; contact 877-444-7330 (TTY: 711).

Member Responsibilities and Assistance

Policy Summary

PayerEmblemHealth

PolicyEssential Plan immigration documentation list

Policy CodePolicy N/A

Change TypeNo material changes

Effective DateN/A

Next Review DateN/A

Key ActionMembers must provide required immigration/identity documents within allowed timeframes or risk losing coverage; assistance available via phone 877-444-7330 (TTY: 711).

SourceLink

On This Page

Documentation Required

Member document submission and assistance — timelines and contact

Members must provide required immigration or identity documents within the allowed timeframes; failure to do so may result in loss of coverage. Assistance is available by phone at 877-444-7330 (TTY: 711).

If documents are not provided within the allowed timeframe, the member may lose coverage.
For help with document submission, call 877-444-7330 (TTY: 711).

Program and Document Definitions

Essential Plan — definition and brief description

TermEssential Plan

JurisdictionNew York State

PurposeState official health plan marketplace program that may require members to submit immigration or identity documents to maintain eligibility and coverage.

Affected membersIndividuals enrolled in the Essential Plan who are subject to documentation verification.

Immigration/identity documents — examples of acceptable documents

Permanent Resident CardI-551 (Green Card)

Temporary Permanent Resident CardTemporary I-551

Employment Authorization CardI-766 (Employment Authorization Document)

USCIS action and notice documentsUSCIS action notice (I-797) or other letters from USCIS or ICE showing identity/immigration status.

Arrival/Departure & status evidenceI-94, approved I-130, I-571 (Refugee Travel Document), I-327 (reentry permit), I-20 or DS-2019 (student/exchange visitor documents).

Other acceptable evidenceImmigration court decisions, hearing notices, ORR letters, ICE supervisory orders, foreign registration records (I-385), notices to appear (I-862), or other official immigration/ICE documents.