Nassau County offers a variety of health insurance options to meet the diverse needs of its residents. Whether you’re looking for individual plans, group coverage, or state-sponsored programs, there are numerous resources available to help you find the right plan. Understanding the different types of coverage, the enrollment periods, and the major providers in the area can help you to make informed decisions about your healthcare. By taking advantage of the available resources and consulting with professionals, you can ensure that you and your family have access to the best possible healthcare coverage.
Complete Guide to Nassau Health Insurance Options
Looking to better understand the Nassau health insurance marketplace. Here we created a comprehensive guide which will help you understand what options are available to you, how to compare and select a plan based on your needs and income, and how to purchase a plan.
What Are the Different Types of Health Insurance Plans Available?
When it comes to medical coverage available, there are several different types to consider, each with its unique features, benefits, and coverage options. Understanding these types can help you make an informed decision that best meets your healthcare needs and financial situation. Here are some of the most common types of plans:
Group Insurance – is one of the more popular plan types in Nassau NY. It’s typically provided by an employer to cover employees and often members of their families, under a single policy. Group health plans are often more cost-effective and usually have richer benefits with larger networks to choose from
Individual Insurance – For those who don’t have access to Employer-sponsored plans, Individual plans can be purchased from the NY State Marketplace. There are several options
Non-Subsidized – these are full premium insurance for individuals or families with incomes higher than 400% of the federal poverty level
Subsidized – for individuals and families that earn between 250 % – 400% of the Federal poverty level
Free NY Health Insurance – for those that don’t qualify for Medicaid, the Essential Plan is a free program for those with incomes up to 250% of the FPL
Child Health Plus – is available for children under 19 who don’t qualify for Medicaid. It’s a full-service coverage that can be free through a low-cost sliding scale based on family income
Catastrophic Insurance – Catastrophic plans are designed for young, healthy individuals ages 19 – 30 who want to cover themselves in case of severe health issues or emergencies. These plans have low premiums but high deductibles and typically cover essential health benefits after the deductible is met.
Self-employed Insurance Plans – very similar to individual plans, however, its often purchased through an association which has stronger buying power through a large member network
Medicare – For individuals aged 65 and older, as well as some younger individuals with disabilities, Medicare offers various coverage options, including Original Medicare (Part A and Part B), Medicare Advantage (Part C), and Medicare Prescription Drug Coverage (Part D).
Medicaid – Medicaid provides health coverage for low-income individuals and families covering a wide range of health services.
Before choosing a plan, it’s essential to evaluate your healthcare needs, budget, and preferred providers. Additionally, consider factors such as premiums, deductibles, copayments, and out-of-pocket maximums to find the right plan for you. Consulting with a licensed insurance agent or using online resources can
What are the Enrollment Periods for Medical Insurance Plans?
The open enrollment period for individual coverage in New York State typically begins in November and often runs through the first month of the new year. for the 2024 – 2025 enrollment period, it starts November first and runs through January 31st
How Can Residents Enroll in a Plan?
Individuals and groups have similar options. they can purchase a plan through a New York health insurance broker, or they can go directly to the NY State of Health marketplace.
Marketplace – By going directly through the marketplace, you have the benefit of shopping and comparing insurance coverages through a website on your own time and always have the option to contact the official marketplace with questions
Broker – by using a broker you have the added benefit of Personalized service and access to multiple plans that may not be available through the market. Also, brokers often have a deep understanding of the marketplace and can help determine your needs, as well as simplify the process for and provide assistance in completing applications
Who are the major health insurance companies operating in Nassau County?
Individuals – have the option of purchasing from the following companies in 2025
Groups – can select from the following companies
How Do Medical Insurance Premiums Vary in Nassau County?
The average 2025 monthly premiums are as follows
| Low | Medium | High | |
|---|---|---|---|
| Bronze | $597 | $801 | $1,324 |
| Silver | $779 | $1,028 | $1,736 |
| Gold | $1,009 | $1,644 | $2,092 |
| Platinum | $1,231 | $1,632 | $2,533 |
Monthly Premiums by Company and Coverage
Anthem BCBS
| LOW | |
|---|---|
| BRONZE | Anthem Gatekeeper X, Bronze ST |
| Premium | $773 |
| Deductible | $3,800 / $7,600 |
| Max. out of Pocket | $9,200 / $18,400 |
| SILVER | Gatekeeper X, Silver ST |
| Premium | $1,045 |
| Deductible | $2,100 / $4,200 |
| Max. out of Pocket | $9,200 / $18,400 |
| GOLD | Anthem Gatekeeper X, Gold ST |
| Premium | $1,306 |
| Deductible | $600 / $1,200 |
| Max. out of Pocket | $7,900 / $15,800 |
| PLATINUM | Anthem Gatekeeper X, Platinum ST |
| Premium | $1,588 |
| Deductible | $0 |
| Max. out of Pocket | $2,000 / $4,000 |
Emblem Health
| LOW | |
|---|---|
| BRONZE | Millenium Bronze ST |
| Premium | $1,324 |
| Deductible | $3,800 / $7,600 |
| Max. out of Pocket | $9,200 / $18,400 |
| SILVER | Millenium Silver ST |
| Premium | $1,736 |
| Deductible | $2,100 / $4,200 |
| Max. out of Pocket | $9,200 / $18,400 |
| GOLD | Millenium Gold ST |
| Premium | $2,092 |
| Deductible | $600 / $1,200 |
| Max. out of Pocket | $7,900 / $15,800 |
| PLATINUM | Millenium Platinum ST |
| Premium | $2,533 |
| Deductible | $0 |
| Max. out of Pocket | $2,000 / $4,000 |
Fidelis Care
| LOW | HIGH | |
|---|---|---|
| BRONZE | Bronze HSA | Bronze ST |
| Premium | $597 | $600 |
| Deductible | $5,500 / $11,000 | $3,800 / $7,600 |
| Max. out of Pocket | $8,050 / $16,100 | $9,200 / $18,400 |
| SILVER | Silver ST | Silver Enhanced |
| Premium | $779 | $799 |
| Deductible | $2,100 / $4,200 | $2,100 / $4,200 |
| Max. out of Pocket | $9,200 / $18,400 | $9,200 / $18,400 |
| GOLD | Gold ST | Gold Enhanced |
| Premium | $1,009 | $1,031 |
| Deductible | $600 / $1,200 | $600 / $1,200 |
| Max. out of Pocket | $7,900 / $15,800 | $7,900 / $15,800 |
| PLATINUM | Platinum ST | ------ |
| Premium | $1,231 | ------ |
| Deductible | $0 | ------ |
| Max. out of Pocket | $2,000 / $4,000 | ------ |
Healthfirst
| LOW | MED | HIGH | |
|---|---|---|---|
| BRONZE | Bronze Leaf ST | ------ | Bronze Leaf Premier NS |
| Premium | $653 | ------ | $676 |
| Deductible | $3,800 / $7,600 | ------ | $8,700 / $17,400 |
| Max. out of Pocket | $9,200 / $18,400 | ------ | $9,200 / $18,400 |
| SILVER | Silver Leaf ST | Silver Leaf Premier Plus NS | Silver Leaf Premier NS |
| Premium | $873 | $908 | $910 |
| Deductible | $2,100 / $4,200 | $2,000 / $4,000 | $3,500 / $7,000 |
| Max. out of Pocket | $9,200 / $18,400 | $9,100 / $18,200 | $9,000 / $18,000 |
| GOLD | Gold Leaf ST | Gold Leaf Premier Plus NS | Gold Leaf Premier NS |
| Premium | $1,055 | $1,100 | $1,102 |
| Deductible | $600 / $1,200 | $850 / $1,700 | $1,125 / $2,250 |
| Max. out of Pocket | $7,900 / $15,800 | $6,200 / $12400 | $7,000 / $14,000 |
| PLATINUM | Platinum ST | ------ | Platinum Leaf Premier NS |
| Premium | $1,328 | ------ | $1,374 |
| Deductible | $0 | ------ | $0 |
| Max. out of Pocket | $2,000 / $4,000 | ------ | $2,000 / $4,000 |
Oscar Health
| LOW | HIGH | |
|---|---|---|
| BRONZE | Classic Bronze ST | ------ |
| Premium | $496 | ------ |
| Deductible | $3,800 / $7,600 | ------ |
| Max. out of Pocket | $9,200 / $18,400 | ------ |
| SILVER | Simple Silver PCP Saver NS | Classic Silver ST |
| Premium | $1,028 | $1,060 |
| Deductible | $9,050 / $4,200 | $2,100 / $4,200 |
| Max. out of Pocket | $9,050 / $18,100 | $9,200 / $18,400 |
| GOLD | Simple Gold NS | Gold ST |
| Premium | $1,252 | $1,371 |
| Deductible | $1,500 / $3,000 | $600 / $1,200 |
| Max. out of Pocket | $6,300 / $12,600 | $7,900 / $15,800 |
| PLATINUM | Platinum ST | ------ |
| Premium | $1,632 | ------ |
| Deductible | $0 | ------ |
| Max. out of Pocket | $2,000 / $4,000 | ------ |
United HealthCare
| LOW | HIGH | |
|---|---|---|
| BRONZE | Compass Bronze NS HSA | Compass Bronze ST |
| Premium | $956 | $1,051 |
| Deductible | $5,500 / $11,000 | $3,800 / $7,600 |
| Max. out of Pocket | $8,050 / $16,100 | $9,200 / $18,400 |
| SILVER | Gatekeeper X, Silver ST | Gatekeeper X, Silver ST |
| Premium | $1,045 | $1,045 |
| Deductible | $2,100 / $4,200 | $2,100 / $4,200 |
| Max. out of Pocket | $9,200 / $18,400 | $9,200 / $18,400 |
| GOLD | Compass Gold ST | ------ |
| Premium | $1,306 | ------ |
| Deductible | $600 / $1,200 | ------ |
| Max. out of Pocket | $7,900 / $15,800 | ------ |
| PLATINUM | Compass Platinum ST | ------ |
| Premium | $1,588 | ------ |
| Deductible | $0 | ------ |
| Max. out of Pocket | $2,000 / $4,000 | ------ |
What Resources Are Available for Nassau County Residents?
Below are the most common medical government resources available
- Adult Cystic Fibrosis Assistance Program (ACFAP)
- Cancer Services Program
- Child Health Plus
- Children & Youth with Special Health Care Needs / CYSHCN
- Early Intervention Program (EIP)
- Elderly Pharmaceutical Insurance Coverage (EPIC)
- Health Insurance Information Counseling & Assistance Program (HIICAP)
- HIV Uninsured Care Programs
- iCanConnect – New York State
- Medicaid (New York State)
- Medicaid Buy-in Program for Working People with Disabilities
- Medicaid Cancer Treatment Program (MCTP)
- Medicare Savings Programs (MSP) (NY)
- Naloxone Co-Payment Assistance Program (N-CAP)
- New York Connects -Aging & Disability Resource Center (ADRC-NY)
- PACE-NY- Programs of All-Inclusive Care for ElderlyMedicaid Managed Long-Term Care
- Prenatal Care Assistance Program (PCAP)
- Technology-Related Assistance for Individuals with Disabilities (TRAID) Program
- Vaccines for Children Program (VFC) – New York City
- Vaccines for Children Program (VFC) – NY State
- Women Infants & Children’s Program (WIC) (NY)
Conclusion