People choosing an Essential Plan insurer ask three things: which plan is best run, which one people complain about, and which one has the most doctors and hospitals. New York publishes data for the first question, only indirect data for the second, and nothing current for the third. This study puts what exists in one place and says plainly where it stops.
The seven insurers, side by side
| Insurer, as named by the state | Overall stars (of 5) | Member experience | Total domain stars (of 35) | Essential Plan members, 2024, statewide | Change from 2023 |
|---|---|---|---|---|---|
| Healthfirst New York | 5 | 5 | 32 | 355,714 | +36% |
| MetroPlus Health Plan | 4 | 3 | 24 | 155,200 | -7% |
| HIP (EmblemHealth) | 3 | 3 | 23 | 106,834 | +18% |
| Fidelis Care | 2 | 3 | 18 | 388,602 | +17% |
| Molina Healthcare | 2 | 4 | 17 | 63,358 | -5% |
| Anthem BlueCross and BlueShield HP | 2 | 1 | 14 | 85,529 | +2% |
| United Healthcare | 1 | 2 | 12 | 143,115 | +27% |
Stars: NYS Department of Health, Managed Care Consumer Guide, Essential Plan, New York City region, report year 2024. Members: eQARR 2024 Essential Plan plan profiles, counted statewide, not only in the city. “Total domain stars” adds the seven domain ratings below.
The order barely moves whichever way you sort quality. Healthfirst leads or ties for the lead on six of seven domains, all but cardiovascular care; UnitedHealthcare and Anthem sit at the bottom on most. Size does not track quality: Fidelis has the most Essential Plan members in the state and 2 stars overall in the city.
Where each plan scores well and badly
| Insurer | Women’s preventive care | Adult preventive care | Respiratory | Diabetes | Cardiovascular | Behavioral health | Member experience |
|---|---|---|---|---|---|---|---|
| Healthfirst | 5 | 5 | 5 | 4 | 3 | 5 | 5 |
| MetroPlus | 3 | 2 | 5 | 4 | 4 | 3 | 3 |
| HIP (EmblemHealth) | 3 | 3 | 4 | 3 | 4 | 3 | 3 |
| Fidelis Care | 2 | 3 | 2 | 2 | 3 | 3 | 3 |
| Molina | 3 | 2 | 2 | 2 | 2 | 2 | 4 |
| Anthem | 3 | 2 | 3 | 2 | 1 | 2 | 1 |
| UnitedHealthcare | 2 | 1 | 2 | 2 | 2 | 1 | 2 |
The Consumer Guide builds these ratings from quality measures the plans report to the state and from member surveys. The ratings compare plans with one another: 5 stars means a plan did well against the other Essential Plan insurers in the region, not against an absolute bar.
Two patterns are useful for a real decision. For someone managing a chronic condition, MetroPlus matches or beats HIP on respiratory, diabetes and cardiovascular care despite a lower adult preventive score. And member experience is the closest thing the state publishes to a satisfaction score: Healthfirst has 5, Molina 4, and Anthem 1. If you have struggled with a plan’s customer service before, that column is the one to read.
What the complaint data covers, and what it misses
The Department of Financial Services publishes an annual Consumer Guide to Health Insurers with an Overall Complaint Ranking. The 2026 edition ranks 55 companies on complaints DFS closed in 2025 and upheld in the member’s or provider’s favor, relative to premiums. The guide states that it does not include data for Medicare, Medicaid, the Essential Plan, Child Health Plus or self-insured plans, and its premium figures exclude Medicare and Medicaid.
So there is no official complaint ranking of Essential Plan insurers. What the guide does show is how three of the same corporate families handle their commercial members:
| Commercial company in the DFS ranking | Related Essential Plan insurer | Rank (of 55) | Complaints closed, 2025 | Upheld |
|---|---|---|---|---|
| UnitedHealthcare of New York, Inc. (HMO) | United Healthcare | 39 | 34 | 18 |
| UnitedHealthcare Insurance Company of New York (EPO/PPO) | United Healthcare | 46 | 301 | 123 |
| HIP Health Maintenance Organization (HMO) | HIP (EmblemHealth) | 48 | 583 | 277 |
| Anthem HealthChoice Assurance, Inc. (EPO/PPO) | Anthem (a different Anthem company) | 52 | 911 | 523 |
| EmblemHealth Plan, Inc. (EPO/PPO) | HIP (EmblemHealth) | 55, last | 1,812 | 801 |
Source: DFS, 2026 New York Consumer Guide to Health Insurers, Overall Complaint Ranking, 2025 data. Across all 55 companies DFS closed 6,630 complaints and upheld 3,237.
Healthfirst, Fidelis Care, MetroPlus and Molina do not appear in the DFS guide at all, so no public complaint figure exists for them. Read the table as a signal about a company’s back office, not a score for its Essential Plan.
Network size: the question no current dataset answers
The Department of Health collects provider network data from Medicaid, commercial and marketplace plans every quarter. The public extracts of that data on Health Data NY stop at the first quarter of 2021. Counting hospitals or doctors per plan from a file that old would describe networks that have since changed, so this study does not publish a count, and any site that ranks Essential Plan networks by size without naming a current source deserves the same doubt.
What the state does keep current is a look-up tool, and it answers the question that decides a plan in practice: is your doctor, clinic or hospital in it?
- Open the NYS Provider & Health Plan Look-Up at pndslookup.health.ny.gov and search by provider or by facility.
- Write down the Essential Plan insurers that list your doctor and the hospital you would use.
- Cross-check in NY State of Health’s plan search, which filters plans by participating hospital or provider.
- Call the doctor’s office and ask: “Do you take the Essential Plan from [insurer], and are you accepting new patients?” The state’s tool itself advises confirming with the provider.
How to use this when choosing or switching
| Your situation | What to weigh first |
|---|---|
| You have a doctor or hospital you will not give up | Network: the look-up tool, then the stars |
| A chronic condition such as diabetes or asthma | The illness domains in the second table |
| You had service problems with a plan before | Member experience rating |
| No strong preference | Overall stars; Healthfirst and MetroPlus lead in the city |
The Essential Plan accepts enrollment year-round, and the state’s October 28, 2026 announcement confirms that remains true for 2027. Plan choice is made through NY State of Health at 1-855-355-5777. Essential Plan basics · Healthfirst vs MetroPlus vs Fidelis, every program · Medicaid plans compared.
Limits of this study
The ratings are the state’s 2024 Consumer Guide, the newest edition in the public dataset, so they describe plan performance before the July 2026 change that moved people between 200% and 250% of the poverty level out of the Essential Plan. Enrollment figures are statewide, from the same 2024 report year, when the Essential Plan still covered that higher-income group. Which insurers offer the Essential Plan in each borough for 2027 is set in NY State of Health’s plan list, which we could not verify for this study; check it before you choose. The DFS complaint figures come from related commercial companies and do not measure the Essential Plan. We will update this page when the state publishes a newer Consumer Guide.
Questions people ask
Which Essential Plan insurer has the best rating in NYC?
Healthfirst New York, with 5 of 5 stars overall in the Department of Health’s 2024 Consumer Guide for the Essential Plan in New York City. MetroPlus has 4 and HIP (EmblemHealth) 3.
Which Essential Plan insurers have the most complaints?
No official complaint ranking covers the Essential Plan: the DFS Consumer Guide excludes it. Among related commercial companies, EmblemHealth Plan, Inc. ranked last of 55 for 2025 complaints and HIP Health Maintenance Organization 48th; Healthfirst, Fidelis, MetroPlus and Molina are not in the DFS guide.
Which Essential Plan has the biggest network in New York City?
No current public dataset counts it. The state’s open provider network extracts end in early 2021. Use the NYS Provider & Health Plan Look-Up to check whether your own doctors and hospital are in a plan.
How many Essential Plan insurers are there in New York City?
Seven are rated for the city in the 2024 Consumer Guide: Anthem, Fidelis Care, HIP (EmblemHealth), Healthfirst, MetroPlus, Molina and UnitedHealthcare. Confirm the 2027 list for your county on NY State of Health.
Can I change Essential Plan insurers?
Enrollment in the Essential Plan is open year-round, so you do not have to wait for open enrollment to act. Ask NY State of Health at 1-855-355-5777 how a plan change works for you and the date it would take effect.
Sources
- NYS Department of Health — Managed Care Regional Consumer Guide data (Health Data NY, dataset 44t3-4uep), Essential Plan, New York City, report year 2024 (checked 2026-11-03)
- NYS Department of Health — Managed Care Regional Consumer Guides (checked 2026-11-03)
- NYS Department of Health — eQARR 2024: Statewide Essential Plan plan profiles (checked 2026-11-03)
- NYS Department of Financial Services — 2026 New York Consumer Guide to Health Insurers (Overall Complaint Ranking, 2025 data) (checked 2026-11-03)
- NYS Department of Financial Services — Health insurance complaint rankings (checked 2026-11-03)
- NYS Department of Health — Individual Provider Network Data: 2021 Quarter 1 (Health Data NY, dataset 3pu3-fqfh) (checked 2026-11-03)
- NYS Provider & Health Plan Look-Up (checked 2026-11-03)
- NYS Department of Health — Open Enrollment for 2027 coverage (October 28, 2026) (checked 2026-11-03)
More in Research and Data: New York Health Coverage and Costs, in Numbers
- Preventable Hospital Visits by NYC ZIP Code: Where the ER Stands In for a Doctor — Tremont's 10457 had 47.01 potentially preventable ER visits per 100 residents in 2023, near 11 times Battery Park City. State data for 173 NYC ZIP codes.
- Medicare Advantage in NYC 2027: Who Leads Each Borough and How Plans Rate — 71.25% of Bronx Medicare enrollees are in Advantage plans. Healthfirst leads four boroughs; its main contract fell to 3.5 stars for 2027. CMS data by borough.
- Medicare 2027 in New York, by the Numbers: How the State Compares With All 50 — New York's cheapest stand-alone Part D plan costs $37.30 a month in 2027, the highest floor of any state. CMS data on Advantage plans and Extra Help, compared.
This page explains how the system works. It is not medical advice. More.