Written by Leonie Dennis
We want to help you make educated healthcare decisions. While this post may have links to lead generation forms, this won’t influence our writing. We adhere to strict editorial standards to provide the most accurate and unbiased information.
From iconic cityscapes and world-class museums to the Adirondacks and rolling Hudson Valley countryside, New York remains a desirable place to live — and understanding your health insurance options here is key to protecting your health and finances.
As of 2025, the uninsured rate in New York reflects a continued trend toward expanding access and steady enrollment thanks to state-run programs and strong ACA participation. If you’re currently without coverage, here’s what you need to know about getting insured in New York.
Health Insurance Options in New York
New York offers a range of health insurance options tailored to residents’ needs, depending on age, income, employment, and family size. Here are the most common coverage types available:
Employer-Sponsored Insurance
Many New Yorkers receive health insurance through their employer. If your workplace offers coverage, this is usually the most cost-effective and convenient option.
ACA Marketplace Plans
The Affordable Care Act (ACA) allows individuals and families to buy health insurance through federal or state Marketplaces. These plans offer essential health benefits, free preventive care, and protection for preexisting conditions.
If you don’t have employer coverage, you may qualify for subsidies to lower your premiums. Use our ACA Subsidy Calculator to check your eligibility.
Starting this year, the Centers for Medicare & Medicaid Services (CMS) is requiring income verification to confirm eligibility for premium subsidies.
ACA Plan Types
ACA marketplace plans are available in four tiers: Bronze, Silver, Gold, and Platinum. Each offers different cost-sharing and coverage benefits:
- Bronze: Lower premiums, higher out-of-pocket costs; best for minimal healthcare usage.
- Silver: Balanced coverage and costs; eligible for cost-sharing reductions (CSRs).
- Gold: Higher premiums with lower out-of-pocket expenses.
- Platinum: Highest monthly costs but lowest expenses when care is needed.
Metal Tier Breakdown:
| Metal Tier | Insurance Company Pays | Consumer Pays |
| Bronze | 60% | 40% |
| Silver | 70% | 30% |
| Gold | 80% | 20% |
| Platinum | 90% | 10% |
Medicaid
New York Medicaid provides free or low-cost coverage for eligible low-income residents. The Medicaid plan includes preventive services, hospital and emergency care, prescriptions, and mental health coverage. Eligibility is based on income, household size, and other criteria.
Short-Term Plans
Short-term medical (STM) plans are not available in New York. The state prohibits the sale of STM plans because they do not meet ACA standards for essential health benefits or consumer protections.
New Yorkers looking for temporary coverage should explore options through the state marketplace, Medicaid, or employer continuation programs such as COBRA.
Children’s Health Insurance Program (CHIP)
Known as Child Health Plus, this program provides coverage to children under 19 who don’t qualify for Medicaid. It helps families who need affordable insurance and includes preventive care, doctor visits, and more.
Student Health Insurance
College students in any state have multiple health insurance options, including staying on a parent’s plan until age 26, enrolling in a school-sponsored plan, or applying for coverage through the ACA Marketplace. Depending on your income and location, you may also qualify for Medicaid, CHIP, or low-cost catastrophic plans, making New York student health insurance accessible and flexible for a wide range of needs.
Medicare
Medicare plans are available for residents aged 65+ and younger individuals with qualifying disabilities. Options include:
- Medicare Advantage Plans (Part C): These are private alternatives to Original Medicare and often include added benefits such as vision, dental, and prescription drug coverage.
- Medicare Part D: Standalone drug plans that work with Original Medicare.
- Medicare Supplement plans (Medigap): Help cover out-of-pocket expenses not included in Original Medicare, such as deductibles and coinsurance.
COBRA Coverage
If you’ve recently lost job-based health insurance, COBRA allows you to temporarily continue your employer-sponsored coverage. This may be a good bridge option while you explore new insurance.
Enrollment Periods in New York
- Open Enrollment for 2026 Coverage: November 1, 2025 – January 31, 2026
During this window, eligible residents can apply for, renew, or change health plans through New York State of Health. - Special Enrollment Period: Available year-round if you experience a qualifying life event, such as:
- Loss of coverage
- Marriage or divorce
- Birth or adoption of a child
- Relocation
- Major change in income
You generally have 60 days from the qualifying event to enroll.
Health Insurance Providers in New York
As of 2025, these insurers typically offer individual and family plans through the New York State of Health marketplace:
Plan availability varies by county. Some insurers may also offer off-marketplace plans or public option alternatives.
Understanding Health Insurance Costs
When selecting a plan, be sure to understand these key cost terms:
- Premium: Your monthly payment to maintain your health insurance.
- Deductible: The amount you pay before your insurance starts to cover services.
- Copayment (Copay): A fixed fee you pay for specific healthcare services.
- Coinsurance: Your share of costs after your deductible is met.
- Out-of-Pocket Maximum: The total you’ll pay in a year before your plan covers 100% of costs.
- In-Network vs. Out-of-Network: Using providers in your plan’s network typically costs less.
Review our comprehensive glossary for clear explanations of key terms to help you make informed decisions.
A team of licensed insurance agents are here to help you compare plans
Bottom Line
Health insurance in New York includes many options—whether from your employer, through the ACA marketplace, or public programs like Medicaid and Medicare. By understanding your choices and enrolling during the correct window, you can get the coverage you need to protect your health and budget.
Need help choosing a plan? Use our ACA Subsidy Calculator to check if you qualify for financial aid or connect with a licensed insurance agent to review your options.
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