New York Insurance Marketplace

The New York State of Health is the official health insurance marketplace of New York. It is a one-stop-shop where individuals, families, and small businesses can shop for and enroll in health insurance plans that fit their needs and budgets. The marketplace was established in 2013 as part of the Affordable Care Act (ACA) and has helped millions of New Yorkers gain access to affordable, quality health insurance.

How does the New York insurance marketplace work?

The New York insurance marketplace works by allowing individuals, families, and small businesses to compare and purchase health insurance plans from various insurers. You can enroll in a plan during open enrollment periods, which typically run from November through January each year. There are also special enrollment periods for those experiencing a qualifying life event, such as getting married, having a baby, or losing health coverage.

When you shop on the New York State of Health website, you can compare plans based on cost, coverage, and benefits. You can also see if you qualify for financial assistance to lower your monthly premiums and out-of-pocket costs. The marketplace offers several types of plans, including Qualified Health Plans (QHPs), Essential Plans, and Child Health Plus.

If you are eligible for Medicaid, the marketplace can help you apply for coverage. Medicaid is a state-administered health insurance program for low-income individuals and families.

Who is eligible to purchase insurance through the New York marketplace?

Individuals and families who live in New York and are U.S. citizens or legal residents are eligible to purchase insurance through the New York marketplace. Small businesses with up to 100 employees can also purchase coverage for their employees through the marketplace.

If you are currently enrolled in a health insurance plan through your employer, you may still be eligible to purchase a plan through the marketplace if your employer’s plan does not meet certain requirements or if the cost of the employer’s plan is more than 9.86% of your income.

What types of plans are available on the New York marketplace?

The New York marketplace offers several types of health insurance plans to choose from, including:

Each plan type has different levels of coverage and cost-sharing, so it’s important to compare plans carefully before choosing the one that’s right for you.

What financial assistance is available?

The New York insurance marketplace offers financial assistance to help individuals and families afford health insurance. The two types of financial assistance available are:

Premium tax credits: These are subsidies that help lower the cost of monthly premiums. They are available to individuals and families whose income is between 100% and 400% of the federal poverty level (FPL). In 2021, the FPL for an individual is $12,880 and for a family of four is $26,500.

Cost-sharing reductions: These are subsidies that help lower out-of-pocket costs, such as deductibles, copays, and coinsurance. They are available to individuals and families whose income is between 100% and 250% of the FPL.

To see if you qualify for financial assistance, you can use the subsidy calculator on the New York State of Health website.

When is open enrollment?

Open enrollment for health insurance plans on the New York marketplace typically runs from November through January each year. However, if you experience a qualifying life event, such as getting married, having a baby, or losing health coverage, you may be eligible for a special enrollment period. You have 60 days after the qualifying life event to enroll in a plan on the marketplace.

FAQ

1. What is the New York State of Health?

The New York State of Health is the official health insurance marketplace of New York. It was established in 2013 as part of the Affordable Care Act (ACA) and allows individuals, families, and small businesses to shop for and enroll in health insurance plans that fit their needs and budgets.

2. Who is eligible to purchase insurance through the New York marketplace?

Individuals and families who live in New York and are U.S. citizens or legal residents are eligible to purchase insurance through the New York marketplace. Small businesses with up to 100 employees can also purchase coverage for their employees through the marketplace.

3. What types of plans are available on the New York marketplace?

The New York marketplace offers several types of health insurance plans to choose from, including Qualified Health Plans (QHPs), Essential Plans, and Child Health Plus.

4. What financial assistance is available?

The New York insurance marketplace offers financial assistance in the form of premium tax credits and cost-sharing reductions to help individuals and families afford health insurance.

5. When is open enrollment?

Open enrollment for health insurance plans on the New York marketplace typically runs from November through January each year. However, if you experience a qualifying life event, you may be eligible for a special enrollment period.