Health Insurance FAQs for New Yorkers

New York offers programs such as Medicaid, the Essential Plan, Qualified Health Plans, Child Health Plus, and private plans. Each serves different income and eligibility levels.

Eligibility is based on income, household size, and immigration status. The Essential Plan covers adults with income up to 200% of the Federal Poverty Level who don’t qualify for Medicaid.

A Qualified Health Plan (QHP) is an insurance plan certified by NY State of Health that provides essential health benefits and follows established limits on cost-sharing.

Yes, New York offers Child Health Plus for children under 19, regardless of immigration status. Costs are based on family income.

Yes. Self-employed New Yorkers can shop for plans through NY State of Health or explore PPO plans and other private options available to individuals.

Yes. If you’re self-employed and not eligible for a group plan elsewhere, you may deduct health insurance premiums when filing federal and NY state taxes.

Yes. Employers with 1–100 employees can offer group coverage. Programs like the Small Business Marketplace provide competitive options.

PPO plans offer out-of-network flexibility and broader choice, while HMOs are more affordable but require referrals and stay in-network. Compare plans here.

You can apply through the NY State of Health Marketplace, directly with insurers, or with broker support. Applications require proof of income and identity.

Typically, you’ll need ID, proof of income (pay stub, tax return), immigration documentation (if applicable), and address verification.

You can change during Open Enrollment or if you qualify for a Special Enrollment Period due to life events like losing coverage, moving, or marriage.

NY State of Health sends renewal notices. You must verify info annually and submit any updated documents to maintain coverage.

Some plans include limited dental and vision for children. Adults may need to purchase separate stand-alone plans.

Yes. Many immigrants qualify for coverage including Medicaid, the Essential Plan, or Child Health Plus depending on status and income.

Income includes wages, self-employment income, Social Security, unemployment benefits, and other taxable sources. NY uses Modified Adjusted Gross Income (MAGI).

Yes. Licensed brokers can help compare plans and enroll you at no extra cost. Contact us here to get started.

No. There’s no state-level penalty in NY, but going without coverage means you risk high out-of-pocket medical bills.

NY State of Health is the official state-run marketplace offering subsidies and public options. Private sites may offer more PPOs or out-of-network coverage.

Log into your account and update your application. Changes may impact your subsidy or plan eligibility, so act promptly.

They let you enroll outside Open Enrollment due to events like job loss, moving, marriage, or having a child. You typically have 60 days to act.