Health Insurance Assistance

What Health Insurance options are available in New York?

In New York State, individuals and families have many low cost, quality health insurance options. While some residents are covered by plans offered through their employer, others may be eligible for health care coverage through a NYS program such as Medicaid, Child Health Plus, or the Essential Plan. Private Qualified Health Plans are also available for purchase. Here is a brief summary of these options and how to access them.

MEDICAID provides essential medical services for people receiving Public Assistance and other low-income persons. Services covered include inpatient and outpatient hospital care, physician services, skilled nursing care, laboratory and X-ray services, vision and dental care, health screening for children, home health care and transportation services.

^*Pregnant individuals who reside in New York State have a higher income limit to qualify for Medicaid, and may be eligible regardless of immigration status.

^*NYS recently extended Medicaid and Child Health Plus postpartum coverage from 60 days to a full year following pregnancy regardless of immigration status or how the pregnancy ended.

CHILD HEALTH PLUS provides free or low-cost health insurance to children under the age of 19 who do not qualify for Medicaid and do not have other health insurance coverage. Children who reside in New York State may be eligible regardless of immigration status. Comprehensive services include doctor visits, lab and x-ray testing, prescriptions, immunizations, emergency treatment, hospital care, and vision and dental services.

The ESSENTIAL PLAN is a health insurance plan that covers all essential services, including doctor visits, lab and x-ray tests, hospital stays, prescriptions, vision and dental, with no premiums or deductibles. Enrollment is open to eligible lower-income people who don’t qualify for Medicaid or Child Health Plus, and are U.S. citizens or meet immigration status requirements.

QUALIFIED HEALTH PLANS are comprehensive, private health insurance plans offered for purchase through the New York State of Health Marketplace that meet Affordable Care Act standards. Depending on income, Premium Tax Credits/Advanced Premium Tax Credits and Cost-Sharing Reductions, may lower the costs of coverage. QHPs are available to NYS residents who are lawfully present in the U.S. and not eligible for Medicaid, Child Health Plus, or the Essential Plan.

How can individuals and families access these health insurance options?

New York State of Health, the Official Health Plan Marketplace, was established as the way for people to shop for, compare and enroll in health coverage. The Marketplace will determine if you qualify for any programs and help to lower the cost of coverage.

There are three ways to connect with New York State of Health Marketplace to enroll in health insurance:

• Apply online through the New York State of Health Website - https://nystateofhealth.ny.gov/
• Apply by phone at 1-855-355-5777 (TTY: 1-800-662-1220)
• Apply with the free help of a trained and certified Enrollment Assistor or Broker in the community. There is a locator tool on the New York State of Health website.

For Child Health Plus, call 1-800-698-4KIDS (1-800-698-4543), and ask about Child Health Plus and Children's Medicaid