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There are various options for health insurance in New York to fit your budget and health needs. You can qualify for help with Marketplace plans or coverage through low-income programs.
New York State Health Plans and the ACA Marketplace
New York offers affordable private health insurance for individuals and families through the Affordable Care Act (ACA or Obamacare) Marketplace, known as New York State of Health. If you’re self-employed with no employees, you qualify as an individual.
- Plans are available in four metal levels: bronze, silver, gold, and platinum.
- Each metal plan covers a percentage of your healthcare costs, from 60% (bronze) to 90% (platinum), with bronze being the least expensive and platinum the most expensive.
- All plans provide comprehensive coverage, including essential health benefits such as hospitalization, maternity care, prescription drugs, and preventive services.
Open enrollment is from November 1 to January 15 each year for private individual and family health insurance plans regulated by the Affordable Care Act (ACA). Self-employed entrepreneurs with no employees can also access these plans.
Subsidies For ACA Plans
Obamacare (ACA) subsidies are financial aid to help pay for your monthly premiums based on your income and household size, not your employment status. So you can still qualify for savings on an Obamacare plan even if you’re unemployed or in between jobs. You can report your expected income from unemployment benefits when applying for coverage.
Subsidies are available if the benchmark plan costs more than 8.5% of your income, with no cap on income level. Our ACA subsidy calculator helps you determine your eligibility for healthcare subsidies based on your income, household size, and location. The tool also accounts for special cases like unemployment benefits and the “family glitch.”
You can enroll through the public exchange at Healthcare.gov or get ACA-qualified coverage in the private Marketplace by buying directly from a private insurer or through a licensed insurance agent.
Plans for Students in New York
- New York College Health Insurance: Enrolling in your school’s health plan is one of the best ways to get low-cost health insurance. Most plans count as qualifying coverage, which means they offer the essential health benefits required by the Affordable Care Act (Obamacare).
- Parent’s Health Plan: You can usually stay on your parent’s health plan until age 26 under the ACA. You can enroll even if you don’t live with your parents, they don’t claim you as a dependent, or you leave school. Coverage typically ends on your 26th birthday.
- New York Obamacare Insurance for Students: You can buy your ACA plan. Keep in mind that you must enroll during the Open Enrollment Period unless you qualify for a Special Enrollment Period.
Medicaid
New York Medicaid provides essential health coverage to low-income individuals, families, pregnant women, children, and people with disabilities. It covers a wide range of services, including doctor visits, hospital stays, and prescription medications.
See if you qualify.
Child Health Plus (CHIP)
CHIP, known as Child Health Plus in New York, is available to uninsured children under 19 who don’t qualify for Medicaid. Families can apply through the New York State of Health Marketplace. Eligible children must be New York residents from low-income households. Some families receive Child Health Plus for free, while others pay a small monthly premium.
Medicare
New Yorkers have several Medicare options. The default is Original Medicare, which includes Part A (hospital) and Part B (medical) insurance, managed by the federal government. Many enrollees add plans sold by private insurance companies, such as Part D (prescription coverage), Medicare Supplement, and Medicare Advantage plans.
Short-Term Medical Plans
New York prohibits the sale of health plans that don’t provide comprehensive coverage or essential health benefits, including short-term health plans that don’t qualify under the Affordable Care Act (ACA).
Next Steps
Whether you’re applying for health insurance in New York for yourself or a family of four, make sure to review all your options. Examine what makes sense for your needs and budget.
Resources
- Health Insurance Marketplace (healthcare.gov)
Click here to apply for coverage, compare plans, and enroll. For questions, call 1-800-318-2596 (TTY: 1-855-889-4325). - New York State of Health: Click here to find a local navigator or certified application counselor to help you get health benefits coverage.
- Understanding Health Insurance
Click here for resources to better understand health insurance and the marketplace.
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