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Are you searching for health insurance in New York? Are you unsure where to start? The Empire State has multiple options for you to choose from. Let us look at a few avenues available for those under 65.
Employer-Sponsored Plans
Employer-sponsored health insurance is a frequent option for those who work full-time. These plans often share costs between employers and employees, making them more affordable than purchasing individual coverage. However, active coverage becomes linked to employment status, which can be a limitation if you change jobs.
Individual and Family Plans
The New York State of Health marketplace is the official health insurance exchange for New York State. It was established under the Affordable Care Act (ACA) to provide a centralized platform where residents can compare and purchase health insurance plans. For those who do not have access to employer-sponsored insurance, the New York State of Health marketplace provides individual and family plans. This coverage is categorized by metal tiers: Bronze, Silver, Gold, and Platinum. Each level varies in terms of premiums and out-of-pocket costs, allowing you to select a plan based on your healthcare needs and budget. The state’s health insurance platform provides financial assistance to eligible individuals and families, including subsidies like Advanced Premium Tax Credits (APTC) and cost-sharing reductions (CSR). These make health insurance in New York more affordable for lower-income residents. Additionally, it offers tools, calculators, and certified navigators to help users select the right plan and apply for coverage.
You can visit the New York State of Health website to learn more. The marketplace offers a range of plans from private insurers along with public programs like Medicaid, Child Health Plus, and the Essential Plan.
Medicaid, Child Health Plus, and Essential Plan
Medicaid offers free or low-cost coverage for low-income individuals and families. In New York, Medicaid eligibility is determined by income and household size. The program covers a wide range of services, including hospital care, prescription drugs, and preventative services. New York’s Child Health Plus program provides affordable coverage for children under 19 who do not qualify for Medicaid. This program includes comprehensive benefits, such as dental, vision, and mental health services, ensuring children receive the necessary care. Another New York exclusive, the Essential Plan, is designed for low-income adults who earn too much to qualify for Medicaid but still need affordable and comprehensive coverage. It offers low premiums (or no premiums) and covers essential health benefits, such as doctor visits, prescriptions, and hospital stays. If you wish to find out more about these three programs that the New York State of Health offers its residents, at-a-glance information cards display information about all three of these programs.
COBRA Coverage
The Consolidated Omnibus Budget Reconciliation Act (COBRA) allows individuals to continue their employer-sponsored insurance after leaving a job. While COBRA provides the same coverage, it can be expensive because you must pay the full premium, including the portion previously covered by your employer.
Short-Term Health Plans and Catastrophic Plans
Short-term health plans provide temporary coverage for gaps between long-term plans. However, New York restricts the availability of these plans due to concerns about limited benefits and high out-of-pocket costs. Unfortunately, people may find it more challenging to find appropriate health insurance in New York due to the state’s decision to prohibit short-term coverage. If your income is low enough, you may qualify for premium tax credits. An alternative option may include a catastrophic plan. Insurers designed catastrophic coverage for individuals under 30 or those with a hardship exemption. These plans have low premiums but high deductibles, making them suitable for healthy individuals who need protection against major medical events.
Have Health Insurance Questions?
We hope that this information on health insurance in New York is helpful for you.
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