The question that actually sorts people
Not “what do you do?” but “who, if anyone, is responsible for offering you coverage?”
| Your situation | Where coverage comes from |
|---|---|
| Salaried, employer offers a plan | The employer plan — but check whether it is fully insured or self-funded |
| Salaried, employer offers nothing | The individual market: Essential Plan, Medicaid, or a marketplace plan with a credit |
| 1099 or self-employed | The individual market, with income estimated by you. How to do that |
| Paid in cash | The individual market, income attested. Why that is a documented route, not an exception |
| Several part-time jobs | Usually none of them, because none of them has you full time. What to do about it |
| Seasonal or through a temp agency | Depends on who the legal employer is, and that is a question worth asking out loud. Which one is it |
| Through a gig platform | Generally the individual market — with one significant New York exception for for-hire drivers. The exception |
Why New York makes this easier than most states
The Essential Plan. At or below 200% of the federal poverty level: $0 a month, no deductible, no enrollment season. That line sits far above what people assume a free program reaches, and it covers a very large share of people working full time in restaurants, shops, salons, construction and home care. What it covers · The 2026 limits by household size.
No season for three programs. Medicaid, the Essential Plan and Child Health Plus accept applications in any month of the year. Nothing about variable work requires waiting until November.
Short-term plans are prohibited here. Every individual plan sold in New York must be comprehensive and cover essential health benefits, so the thin product marketed to gig workers elsewhere cannot be sold to you at all.
Immigration status is not the barrier it is elsewhere. Children are covered regardless of status, pregnancy is covered through Medicaid regardless of status, hospital financial assistance may not consider status, and NYC Care has no status requirement and no income cutoff for membership.
The thing that is not a health insurance question at all
If you are hurt at work, the bill does not belong to your health plan. It belongs to workers’ compensation, and the difference is not academic: workers’ comp pays 100% of the necessary treatment with no copay, no deductible and no share for the worker.
Two deadlines start the day it happens: 30 days to notify the employer, preferably in writing, and two years to file the claim form with the state board.
And the fact that changes the most for this city’s workforce: the claim form does not require a Social Security number, and every worker injured on the job in New York can file regardless of immigration status. What to do the day it happens.
One page per kind of work
Self-directed work. Self-employed and 1099 · Paid in cash · Running a small business
Shift and hourly work. Restaurant work · Several part-time jobs · Seasonal and temp agency work
Specific trades. Home care and home health aides · Construction · Domestic work: nannies, cleaners, caregivers · Rideshare, for-hire driving and delivery
When something happens. Injured at work · and when the job itself changes, every clock that starts.
Where to start if you are reading this with no coverage
- Estimate this year’s household income, not last year’s and not the best month. Everything follows from that number.
- Run the five-question check. The navigator takes less time than reading a plan brochure.
- If the Essential Plan or Medicaid fits, apply now. No season, no qualifying event, no waiting.
- If nothing fits yet and you need care this week, a community health center charges on a sliding scale by household income and sees uninsured patients as routine. What to do with no insurance.
Questions people ask
My job does not offer health insurance. Is that legal?
Generally yes below 50 employees. What fills the gap in New York is the Essential Plan — $0 a month at or below 200% of the federal poverty level, with no deductible and no enrollment season.
I get paid in cash. Can I still get covered?
Yes. New York accepts an attestation of income cross-checked against electronic data, and paper documents are requested only where the two do not match.
I am self-employed. What income do I report?
The income you expect for the current year, after business expenses. Estimating it is a normal part of the application, and it can be revised during the year.
I was hurt at work. Does my health insurance pay?
No — workers’ compensation does, and it covers the necessary treatment with no copay or deductible. Tell the employer within 30 days, in writing, and file the claim form within two years.
Does immigration status stop me from filing a work injury claim?
No. The claim form does not require a Social Security number, and every worker injured on the job in New York can file regardless of status.
I work three part-time jobs. Who covers me?
Usually none of them, because none has you full time. That puts you in the individual market, where your combined income decides the program.
In this section
Injured at Work: The Sentence to Say in the Emergency Room
Hurt at work? Workers' compensation pays the whole medical bill with no copay or deductible, if the claim exists. The 30-day notice, and the two-year form.
Self-Employed and 1099: Estimating an Income You Do Not Know Yet
Self-employed? The application asks what you expect to net this year, after expenses. How to estimate it, and the 30-day rule that prevents a tax-time surprise.
Paid in Cash: How Income Is Proven When There Are No Pay Stubs
Paid in cash? New York accepts an attestation of income, checked against data, and asks for paper only where the two do not match. It is not a disqualification.
Driving and Delivering: The Coverage You Have Without Knowing It
New York for-hire drivers get workers' compensation from the Black Car Fund, plus telemedicine, dental and vision at no cost. None of it is health insurance.
Domestic Work: The Hour Counts That Decide What You Are Owed
Domestic workers in New York: 40 hours a week for the same household brings workers' compensation, 20 brings disability and paid family leave. How hours count.
Restaurant Work: Tips, Variable Hours and the Coverage Nobody Mentions
Most New York restaurants need not offer coverage, and tips count as income. A full-time restaurant income often falls in the Essential Plan's free tier.
Home Care Work: Covering the People Who Do the Covering
For home health aides, coverage depends on who employs you: an agency, CDPAP or a household. What union funds cover, and the thresholds written in hours.
Construction: Two Different Systems, and Saying the Wrong One Costs You
On a construction site, the first sentence at the hospital desk decides whether workers' compensation pays the whole bill. Immigration status does not matter.
Several Part-Time Jobs: Full-Time Hours, Nobody's Employee
Work fifty hours across three employers and none of them owes you coverage. The income still adds up for eligibility, and that combined number is usually the good news rather than the bad.
Seasonal and Temp Agency Work: Who Is Actually Your Employer
With an agency placement, only one of two companies is your employer for benefits. Which one, and why the off-season is when coverage is cheapest.
Running a Small Business: What You Owe, What You Do Not, and What You Are Missing
Below 50 employees you need not offer coverage; below 20 you are outside federal COBRA but not New York's continuation. Workers' compensation still applies.
Sources
- NY State of Health — Essential Plan (checked 2026-09-14)
- NYS Workers' Compensation Board — file a claim (checked 2026-09-14)
- NYS Department of Financial Services — state continuation coverage extension to 36 months (checked 2026-09-14)
More in Coverage by the Kind of Work You Do
- Running a Small Business: What You Owe, What You Do Not, and What You Are Missing — Below 50 employees you need not offer coverage; below 20 you are outside federal COBRA but not New York's continuation. Workers' compensation still applies.
- Injured at Work: The Sentence to Say in the Emergency Room — Hurt at work? Workers' compensation pays the whole medical bill with no copay or deductible, if the claim exists. The 30-day notice, and the two-year form.
- Self-Employed and 1099: Estimating an Income You Do Not Know Yet — Self-employed? The application asks what you expect to net this year, after expenses. How to estimate it, and the 30-day rule that prevents a tax-time surprise.
This page explains how the system works. It is not medical advice. More.