Find the Cheapest Health Insurance Quotes in Your Area
Affordable health insurance in New York is available for purchase through the state marketplace, or it can be obtained through Medicaid if your household income falls below 138% of the federal poverty level. To help you find the best coverage, we analyzed Silver health insurance policies available in the most populous counties and found that the Fidelis Care Silver Dep 25 was the cheapest plan available. However, there are 19 insurers offering health plans in New York, and where you live will determine what companies and policies are available.
New York Individual Health Insurance Plans: Overview
You can purchase health insurance in New York through the NY State of Health marketplace. Health insurance in New York is one of the most heavily regulated in the United States. While the Affordable Care Act, also known as Obamacare, tightened the rules as to what insurers are permitted to use in pricing your plans, New York's regulations are even more restrictive.
Most other states allow insurers to use your age, as well as smoking habits, in determining your rates, with smokers and older consumers paying more. But, in New York, insurers are prohibited from using any personal information for calculating premiums, using only where you live as a factor. For both individual plans and small-business plans, all consumers living in a specific location pay the same price for health insurance. This results in younger New York residents paying more for health coverage than they would in other states, while older residents pay less than they would otherwise.
Open enrollment in New York begins on Nov. 1 and continues through Jan. 31. If you are a first-time buyer then you will be able to purchase a health insurance plan on the first date (Nov. 1), while people who want to renew a plan will be able to start Nov. 16. It is important to note that if you buy a health plan before Dec. 15, then your effective coverage would begin by Jan. 1. New York also lists brokers through their online marketplace portal that can provide guidance and help with enrolling in a health plan.
Cheapest Health Insurance by Metal Tier
To help you to compare prices and choose the best policy, we have identified the cheapest health insurance plans available in the state of New York. The plans shown below may not be available in your county but are useful in your preliminary search for choosing a metal tier that is both affordable and provides adequate medical benefits.
|Metal Tier||Cheapest Plan||Deductible||Out-of-Pocket Maximum||Monthly Cost for an Adult Individual|
|Catastrophic||Oscar Simple Secure Dep 25||$7,900||$7,900||$162|
|Bronze||Fidelis Care Bronze Dep 25||$4,000||$7,600||$396|
|Silver||Fidelis Care Silver Dep 25||$1,700||$7,500||$562|
|Gold||Fidelis Care Gold Dep 25||$600||$4,000||$671|
|Platinum||Fidelis Care Platinum Dep 25||$0||$2,000||$813|
Health insurance is offered at five different tier levels in New York: Catastrophic, Bronze, Silver, Gold and Platinum. As you can see above, when the tier level increases, the monthly premium becomes more expensive, while the deductible and out-of-pocket maximum decrease.
Finding the Best Health Insurance Coverage in New York
The best health insurance policy for your family will depend on the availability of plans in your area, as well as your medical and financial situation. When deciding on the right type of plan, you should carefully review the premiums and deductibles for each metal tier and determine what is affordable. Generally, if you have an emergency savings and don't expect to have significant health or medical expenses, then a lower metal tier plan with more affordable premiums would make more financial sense.
Gold and Platinum Plans: Best if You Expect High Medical Costs
Gold and Platinum plans are the highest tier health insurance policies available in New York. These plans often have the most expensive monthly premiums but come with lower deductibles and out-of-pocket maximums. For this reason, Gold and Platinum plans can be the most cost-effective for those with higher medical costs, as you would reach the deductible quickly and then be eligible to begin co-insurance with your provider. For example, if you require prescriptions drugs that are expensive and need to be refilled every month, an upper-tier health plan could be the right choice.
Silver Plans: Best for People with Low Income or Average Medical Costs
Silver plans are middle ground policies that fall in between Gold and Bronze tier plans with regard to premiums and out-of-pocket expenses. We would recommend a Silver plan in most situations—but if you are very healthy, Bronze may be best in terms of cost-effectiveness. On the other hand, if you expect a lot of medical expenses, then a Gold plan may better fit your needs.
Silver plans are eligible for cost-sharing reductions in New York if you fall below 250% of the federal poverty level. If this applies to you, you would be able to receive discounts on the deductibles, coinsurance and copayment that you are required to pay.
Bronze and Catastrophic Plans: Best for Young, Healthy Individuals
Bronze and Catastrophic tiers have the lowest premiums available on the New York marketplace but also the highest deductibles and cost-sharing. These metal tier plans should only be considered if you are in great health and do not expect to have a large medical cost during the plan year.
Bronze plans are available to all consumers, but Catastrophic tiers have eligibility requirements—the plan is only available if you are under the age of 30 or have a hardship exemption.
Short-Term Health Insurance in New York
Short-term health insurance plans are not available for purchase in New York. Furthermore, New York state prohibits the sale of these insurance plans due to regulations that require all health plans to be guaranteed renewable and cover the minimum essential benefits.
Most short-term plans typically do not cover the essential benefits (maternity, mental health, prescription drugs usually are not covered) and thus are not offered on the New York state health insurance marketplace.
Find the Cheapest Health Insurance Quotes in Your Area
Age 29 Rider Coverage Expansion
Under the Affordable Care Act, young adults can be covered under their parents' health insurance plans up until the age of 27. Because of the way insurance is priced in New York, it is preferable for young adults to stay on their parents plans until the legal limit, since the additional cost is at most 70-85% of the parent's health plan premium.
New York also allows health insurance companies to offer an age 29 coverage option. Parents pay a little more for their health insurance in exchange for having their children stay on the family plan until the age of 29. For example, say your young adult child has passed the age of 27 but does not have a job or sustainable income to pay for their own insurance. In this case, you could pay a small extra premium along with your normal health insurance rate that would allow your coverage to support your son or daughter. To qualify the young adult must be:
- 29 years old or younger
- Not insured or eligible for insurance through their employer
- Live, work or reside in New York state or the insurance carrier's coverage area
New York Health Insurance Companies
There are currently 19 insurers that sell individual plans on the New York health insurance marketplace:
- Healthplex Insurance Co.
- Dentegra Insurance Company of New England
- Emblem Health
- Independent Health
- Solstice Health Insurance Co.
- Fidelis Care
- MetroPlus Health Plan
- MVP Health Care
- Univera Healthcare
- BlueShield of Northeastern New York
- Excellus BlueCross BlueShield
- BlueCross BlueShield of Western New York
- Empire BlueCross (Medical Upstate)
- Empire Blue Cross Blue Shield (Medical Downstate)
Some of these insurers may not be available depending on where you live—the availability of insurers and health plans changes by county, so your location will directly impact your coverage options.
Medicaid Health Insurance Coverage in New York
New York's Medicaid program is a form of health insurance for those who may not have the financial capacity to pay for an individual plan. Qualifying for Medicaid is primarily a function of your income and household size. Through the state's adoption of Medicaid expansion, most households with Modified Adjusted Gross Incomes (MAGI) under 138% of the Federal Poverty Level (FPL) are eligible for Medicaid coverage in New York.
The income limits for children and pregnant women are slightly higher than those for adults. Children up to the age of 19 are eligible for Children's Medicaid if the household income is under 154% of the FPL, while pregnant women and infants up to the age of 1 are eligible if the household earns less than 223% of FPL. The following table illustrates the maximum monthly income a family can have in order to qualify for the Medicaid thresholds in New York.
|154% of FPL||223% of FPL|
How Does Medicaid Coverage Work?
In New York, if you apply for Medicaid you will be asked to select a health plan managed by an insurance carrier, such as United Healthcare or Empire BCBS. These same insurance companies also sell individual health insurance policies and small-business coverage, and the plans themselves operate similarly. Each Medicaid plan will come with a network of doctors and health care providers that accept the insurance. However, health plans offered as part of the Medicaid program may have a different network of doctors when compared to other plans offered by the same insurance carrier. If you have a physician that you prefer, it's important to make sure that they will be part of the new network.
Average Cost of Health Insurance by Family Size
Along with your county of residence, the number of people covered under the health plan will affect the premiums you pay. Below we have provided the average cost of a Silver tier health plan for a variety of family sizes. Note that for a family the average cost for a Silver policy is $2,054 no matter how many dependents are covered under the health insurance plan.
|Family Size||Average Monthly Cost of Silver Plan|
|Parent and Child Only||$1,225|
Child Health Plus Coverage for Children
In New York, Child Health Plus is a health insurance program for children in households that have incomes too high to qualify for Medicaid but under 400% of the Federal Poverty Level. Like Medicaid, Child Health Plus plans are managed by the same insurance carriers on the individual and small-business market.
Families with children under the age of 19 that qualify for Child Health Plus pay significantly lower health insurance rates for covering their child. The amount a family contributes is based on the size of family and their household income, with premiums per child ranging from $9 to $60 per month.
For families with multiple children, the maximum contribution they will have to make is three times the per-child premium. For example, if you fall into the $9 per child threshold group, then the maximum you would need to pay for all your children would be $27 even if you purchase coverage for more than three children.
Maximum Monthly Income to be Eligible for Child Health Plus: By Number of Children
|Monthly Health Insurance Cost (Per Child)||1||2||3||4||5|