Healthy New York Insurance For Sole Proprietors And Small Businesses

Individuals, sole proprietors, and small businesses can now qualify for comprehensive health insurance coverage through Healthy New York (NY). With the streamlined benefit package and state funding, you and your family can now take advantage of more affordable health insurance. Additionally, uninsured sole proprietors and workers not provided with health insurance by their employers may also purchase the plan through the Healthy New York insurance program.

Benefits and Coverage
The standardized benefit package offered by Healthy NY includes inpatient and outpatient hospital services, emergency services, preventive and primary care, maternity care, diagnostic and x-ray services, and physician services. You now have the option of choosing a benefit package that includes a limited prescription drug benefit or one without a prescription drug benefit.

Costs and Rates
Reduced-cost health insurance is possible through Healthy NY. The package can be purchased from any of New York’s health maintenance organizations (HMOs), and other New York State licensed health plans. HMOs charge a monthly premium and rates may vary according to county and by HMO.

Eligibility
To qualify for the Healthy NY program for individuals and sole proprietors you must meet all five requirements:
1. You must be a resident of New York State and not eligible for Medicare.
2. You or your spouse must have worked in the past 12 months.
3. You must not be eligible for health insurance provided by your employer.
4. You must meet income guidelines.
5. You must be uninsured for 12 months before applying for Healthy NY or have lost coverage because of a specific event.

HMO Providers
Included in the list of health insurance companies include Aetna, Atlantis Health, CDPHP, ConnectiCare, Empire Blue Cross Blue Shield, Excellus, HealthFirst, and Oxford Health Plans. All HMOs in New York State offer Healthy NY health insurance benefit packages to eligible businesses and individuals. If you decide to change HMOs, you may do so at any time by submitting a new application to a new HMO. However, you should keep in mind that payments towards any deductibles will not be carried over to the new HMO, additionally, you have to meet all of the eligibility requirements at the time of your new application.

Re-certification and Changes in Eligibility Requirements
Healthy considers changes in your household size, income, and other factors after your Healthy NY enrollment. Mid-year changes will not cause you to lose your coverage immediately. Healthy NY conducts an annual recertification process to review your eligibility.

Each year, you are required to complete a recertification form that shows your eligibility for Healthy NY. Your chosen HMO will provide you with this form and inform you of its due date. Failure to meet the eligibility requirements at the time of recertification will result in the discontinuation of your participation in the program. Employment is not necessary when you recertify your eligibility.