If you’re a New Yorker without health insurance — because you don’t qualify, because you can’t afford a plan, or because immigration status has kept you out of the system — there is one program designed specifically for you, and it does not appear in most insurance comparison articles. It is called NYC Care, it is run by NYC Health + Hospitals (the city’s public hospital system), and as of 2026 it remains the most underused public-health access program in the five boroughs.
NYC Care is not insurance. That distinction matters, because every time we publish a piece about Medicaid or the Essential Plan, readers email us asking, “But what if I don’t qualify for any of those?” This is the answer. And unlike the federal marketplace, it asks nothing about immigration status, takes no premium, and starts the first appointment within two weeks of enrollment.
What NYC Care actually is — and what it isn’t
NYC Care is a healthcare access program operated by NYC Health + Hospitals. According to ACCESS NYC, the city’s official benefits portal, the program “gives you access to your own doctor and services at little or no cost” at any of the NYC Health + Hospitals locations citywide.
What it is not: a private insurance plan that you can take to any doctor. NYC Care only works at NYC Health + Hospitals facilities — the city’s 11 public hospitals, the Gotham Health network of community clinics, and partner sites. If you have a primary care doctor in a private practice, NYC Care will not pay that doctor. You would switch to a primary care doctor inside the H+H system.
The trade-off is straightforward: you give up choice of any provider in the city, and in return you get coordinated, low-or-no-cost care through one of the largest public health systems in the United States.
What it covers
Per ACCESS NYC and the official NYC Care site, the program covers the full range of primary and specialty care you’d expect from a major hospital system:
- A primary care doctor of your choosing inside the H+H system
- Preventive care including vaccinations, screenings, mammograms, and routine lab work
- Mental health support and substance use treatment
- Access to low-cost prescription medications, available day or night through the program’s 24/7 customer service line
- Specialty care referrals (cardiology, dermatology, OB/GYN, and others) within H+H
- Dental services through Gotham Health locations
One detail worth highlighting: NYC Care explicitly includes mental health and substance use services. For New Yorkers who have avoided dealing with depression, anxiety, or a substance issue because they assumed they could not afford help, this program is the entry point.
Cost
According to the official program description, “There are no membership fees, monthly fees, or premiums.” Your fee for a clinic visit is set on a sliding scale based on family size and income. For New Yorkers earning under 200% of the Federal Poverty Level, visit fees are generally $0. Prescription medications are also subsidized.
This is the part that surprises most people. There is no monthly bill. You are not paying for coverage you might not use. You pay only when you receive care, and that amount is calibrated to what you actually earn.
Who is eligible
Three eligibility requirements, as published by ACCESS NYC:
- You live in one of the five boroughs of New York City.
- You do not qualify for any health insurance plan available in New York State.
- You cannot afford health insurance based on government guidelines.
The immigration-status section on the official ACCESS NYC page is unambiguous: “You may be eligible regardless of your immigration status.” The program also states that “NYC Care enrollment does not pose a risk under the ‘public charge’ rule.” The application is confidential, and according to the official program description, no information is shared with immigration authorities.
If you have been screened for insurance through the NYS of Health Marketplace and were found ineligible, you can bring a printout of that determination and the enrollment process is faster.
Documents you’ll need
To enroll, the program asks for proof of four things:
- Identification (any government-issued ID, IDNYC works)
- New York City residency (a lease, utility bill, or piece of mail)
- Household income (a pay stub, tax return, or sworn statement if you have no documentation)
- Household size
If you cannot produce all four, the program’s official guidance is that “a counselor still may be able to help you enroll.” Call the main line before assuming you’re locked out.
How to Take Action
There are three ways to enroll, and you can typically be enrolled and assigned a primary care doctor on the same call:
1. Call the enrollment line
1-646-NYC-CARE (1-646-692-2273). The line is staffed in multiple languages. Tell them you want to enroll in NYC Care. Have your documents nearby, but if you don’t have them all, ask the counselor what flexibilities are available.
2. Apply in person at an NYC Health + Hospitals location
Walk into any NYC Health + Hospitals hospital or Gotham Health clinic and ask to speak with a Financial Counselor. Every H+H site has them. The full list of locations is at nyccare.nyc/locations.
3. Apply through a community partner
NYC Care works with community-based organizations across all five boroughs that help people enroll. Many of these partner organizations operate in languages other than English and Spanish. The list of community partners is at nyccare.nyc/community-based-organization.
What to expect after enrollment
Per the official program guidance, you can get your first appointment within two weeks or less. You will be assigned a primary care doctor at an H+H facility near you, and that doctor becomes your home base for all care. Specialty referrals, prescription pickups, and the 24/7 nurse line all run through the same system.
How NYC Care fits with other programs
If your situation changes — you get a job with insurance, your income drops enough to qualify for Medicaid, or you become eligible for the Essential Plan — you can transition out of NYC Care into that coverage. Counselors at H+H facilities will help you make that transition without a gap in care. For seniors aging into Medicare, the same financial counselors can help you coordinate.
NYC Care is not meant to be a permanent endpoint for everyone. It is meant to be the floor: no New Yorker in any of the five boroughs should be without a doctor, regardless of what’s happening in their life. That floor has existed since 2019 and remains in place in 2026.
Why this program is underused
The most common reason eligible New Yorkers don’t enroll is that they have heard of Medicaid and the Essential Plan but have never heard of NYC Care. The second most common reason is fear that enrolling will create an immigration paper trail. The program’s official guidance on both points is clear: enrollment is confidential, information is not shared with immigration authorities, and the program does not affect public charge determinations.
If you’ve been avoiding the doctor because you assumed you couldn’t afford it or weren’t eligible for anything, this is the call to make.
FAQ
Is NYC Care free?
There are no premiums or membership fees. Visit fees are based on a sliding scale tied to your family size and income. For households under 200% of the Federal Poverty Level, fees are generally $0.
Will enrolling in NYC Care affect my immigration status?
According to the program’s official guidance, enrollment does not pose a risk under the public charge rule, and no information is shared with immigration officials.
What’s the difference between NYC Care and Medicaid?
Medicaid is health insurance that can be used at any provider that accepts it. NYC Care is a healthcare access program that works only at NYC Health + Hospitals facilities. If you qualify for Medicaid, you should enroll in Medicaid. NYC Care is for New Yorkers who do not qualify for any other coverage.
How long does it take to see a doctor after enrolling?
Per the official program description, first appointments are available within two weeks or less of enrollment.
Can I keep my current doctor?
Only if your current doctor is inside the NYC Health + Hospitals system. NYC Care does not pay private-practice providers outside the H+H network.
