Aetna

Affinity Health Plan

Capital District Physician Health Plan (CDPHP)

Crystal Run Health Plan

EmblemHealth

Empire (BlueCross BlueShield)

Fidelis Care

Health Insurance Plan of Greater New York (HIP)

HealthFirst

HealthNow (BlueCross BlueShield)

Independent Health

MetroPlus Health Plan

Molina Healthcare

MVP Health Care (Mohawk Valley Physicians Health Plan)

Oxford

United Healthcare of New York

WellCare of New York

YourCare Health Plan

What to Know When Shopping for a Buffalo Health Insurance Plan

Below are some of the most commons concerns when shopping for a Buffalo health plan.

Are Your Buffalo Physicians Within the Network? – Prior to making a purchase, it’s important to verify that your physician(s) are included in the network. Visiting an out-of-network physician can lead to significantly higher costs compared to seeing an in-network provider. Don’t simply inquire at the doctor’s office about their acceptance of a particular plan before enrolling. It’s important to double-check with the insurance company or an agent to ensure your doctors are indeed in-network. Why is this important? Remember that if an out-of-network provider recommends treatment, all services rendered by that provider will be deemed out-of-network, even if the associated facilities and other providers are in-network.

Reduced Monthly Premiums May Lead to Increased Expenses – There’s a straightforward principle: the lower your monthly payment, the more likely you are to incur greater costs overall. If you are generally healthy and do not anticipate any medical issues or frequently require prescriptions, a lower-cost plan might be the best choice for you. However, if you have high medical expenses and regularly use prescriptions, opting for a plan with a higher monthly premium could ultimately save you money. Make sure to take your current health status into account when selecting an insurance plan.

Health Insurance is a Binding Agreement – When you select a plan, both parties commit to uphold the terms of the agreement (typically for a duration of one year). If you find yourself dissatisfied with your plan, you cannot approach your provider midway through the year to request a change in coverage. You will need to wait until your agreement concludes. Furthermore, if you purchase an individual plan through your state exchange or healthcare.gov and then let that plan expire or discontinue coverage, you will be ineligible to obtain coverage on that exchange for the remainder of that calendar year. Therefore, ensure that you select the appropriate plan that meets your requirements before finalizing the agreement.

Various Insurance Coverage Options – EPO, PPO, POS, HMO, HDHP, and HSA. The first four are abbreviations that represent different kinds of insurance plans, each offering varying degrees of flexibility in accessing specialists and obtaining care outside of your network or state. Additionally, these plans may have different requirements regarding referral processes. If you frequently consult specialists who are outside your network, it would be beneficial to choose a plan that provides that flexibility. Similarly, if you travel often for work or reside in multiple states throughout the year, a plan that accommodates such needs may be vital. The last two options, HDHP and HSAs, enable you to create a tax-exempt savings account specifically for eligible medical expenses. For a more comprehensive understanding of these coverage types, please consult the following article.

Metal Levels – To simplify shopping and comparisons, a metal classification system was established to represent various insurance coverage tiers. These tiers are divided into four categories based on their actual metal value: Bronze, Silver, Gold, and Platinum, each corresponding to the level of coverage provided by the respective plans. Generally, a Bronze plan is designed to cover 60% of your medical expenses and includes a maximum out-of-pocket limit, which does not equal the remaining 40% but rather is a set threshold for most Bronze plans. Silver covers 70%, Gold covers 80%, and the highest tier, Platinum, covers 90%. Depending on your healthcare needs, you should be able to easily compare the appropriate metal level. For instance, if you have minimal healthcare requirements, a Bronze plan might be the best fit for you. Conversely, if you have significant health issues, opting for a Gold or Platinum plan, despite the higher costs, might ultimately save you more in the long run. All qualified metal plans are available for sale through the NY State of Health Marketplace.

Are Essential Health Benefits Included? – One way to make sure that the plan you are purchasing or planning to purchase includes the 10 essential health benefits is to select a plan offered through the exchange. All plans available on the exchange are required to cover these health benefits. This guarantees a baseline level of coverage, as mandated by the Affordable Care Act. Why is a minimum standard necessary? The expense of medical care can be exorbitant without insurance, potentially resulting in financial disaster. Confirming that a plan encompasses these minimum benefits acts as a protective measure.

Frequently Asked Buffalo Health Insurance Questions

I’m moving to Buffalo from out of state, do I need to change my health insurance.

Yes, when moving from one state to another, it’s very likely that your insurance company would not offer the same coverage, benefits and network out-of-state

I’m moving from New York City to Buffalo, do I need to change my personal health insurance. 

While there is a possibility that your insurance company operates in all New York Counties, it’s advisable to contact the insurance company to ensure that your network of providers and services extends to Erie County

Are there any free health insurance plans in Buffalo for me any my child

Yes, however you do need to qualify mostly based on income. For yourself there is the Essential plan and Medicaid, and for your child there’s Child Health Plus