NY Individual Health Insurance Plans

Now that open enrollment is here, many New Yorkers will be looking for their individual health insurance plans and options. Each year during this time many questions come up about what type of plan to buy and where to buy it. Some people will be simply renewing their existing plans, while others will be shopping for their first time.

No matter if you are a first-time buyer or a seasoned health insurance shopper, understanding your plan options for 2017 could be a challenge. Many changes have taken place in the individual marketplace which could leave you frustrated and discouraged.

Should You Buy A Health Plan On Exchange or Off Exchange?

Public Health Exchanges

“On Exchange” health plans are purchased on the public exchanges such as; Healthcare.gov or a state exchange such as NyStateofhealthny.gov The public exchanges came into existence because of the Affordable Care Act (ACA) in 2014 where consumers can shop for a health plan, compare policies, enroll in a plan and receive a subsidy if you are eligible.

If your current individual health plan is still available, you should have received notification describing any plan changes, price increases and instructions how to renew. If you are pleased with your current health plan, there is no need to go through the trouble of shopping for a new one.  If you plan to renew your plan, it is very important that you submit the required paperwork sent by the insurance company before the deadline of December 15th for continued coverage beginning January 1st.

However, if you are like many people who will be losing their current health plan and it is not being renewed, you will need to shop the public exchanges to find a new plan. When searching for plans on the public exchanges, you can search your current doctor, hospitals and even medications you are taking. The search results will match your requirements to the best plans available. Just keep in mind when considering to by a plan on exchange, not all doctors/hospitals accept public exchange policies.

Some people could qualify for premium tax credits or subsidies for individual health insurance plans purchased on the public exchanges. You can qualify for a Government subsidy if: your employer does not offer a health plan or your income level is below 400 percent of the poverty level. Check the Internal Revenue Services (IRS) website for more detailed information regarding subsidies.

Private Health Exchanges

Public health exchanges are not the only options available for individual health insurance. Although many people are being encouraged by the Government to purchase health insurance on the public exchanges, individual health insurance policies are also available off-exchange. An off-exchange policy is a policy that can be purchased directly from the insurance company. You can utilize the services of a health broker such as our company or you can call the insurance company direct and ask them for information about the available health plan options.

NY Individual Health Plan Options

The individual health insurance plan pricing and plan designs will be the same on exchange or off exchange. However, some plans that are available privately may not be available on the public exchanges and vice versa The insurance companies reserve the right to offer different plan designs for different venues. Although all the plans sold in the individual market – on or off the exchange – still must meet the ACA’s requirements.

Plans that are sold on or off exchange must adhere to the requirements of The Affordable Care Act and be certified as Quality Health Plans (QHP’s). Under the ACA, a QHP must follow the cost sharing guidelines and cover essential health benefits with no life time or annual maximums.

There are 4 “metallic tiers” to choose from: Platinum, Gold, Silver and Bronze. The Platinum plans have the least out of pocket expenses but the highest premiums. The Bronze plans have the lowest premiums but the highest out of pocket expenses for medical care.

What Private NY Individual Health Plans Are Available?

The following are some of our top choices for private individual health insurance in the New York marketplace. To download rates and plan designs, go to our Individual Health Insurance page.

CareConnect Individual Plans:

CareConnect was Founded in 2013 by the North Shore-Long Island Jewish Health System, (Now called Northwell Health). This insurance company is the low-price leader in New York. CareConnect offers several individual as well as group health plans (if you are a small business owner) to choose from. Their network of doctors and hospitals is rapidly growing in the State of New York and their best coverage areas are in the 5 boroughs, Long Island and Westchester County.

Breaking News! CareConnect recently announce a partnership with The Imbert Cancer Center which is one of the largest cancer treatment centers in the tristate area. This partnership already enhances their current relationships with Monter Cancer Center on Long Island, the Montefiore Einstein Center for Cancer Care in the Bronx and the Maimonides Cancer Center in Brooklyn.

CareConnect plans are EPO health plans that do not require referrals. Out of state coverage is provide by their affiliation with the Multiplan National Network.

MVP – (Mohawk Valley Physicians)

MVP specializes in providing health insurance coverage in upstate New York. However, their network is rapidly growing to lower Westchester county and New York City.
The company was founded in 1986 by consortium of doctors who felt they could provide better coverage than some of the current health insurance companies already in existence in New York. They are located Schenectady NY and have more than 500,000 health care providers and facilities in their network

MVP offers a wide variety of individual and group health plans including EPO, PPO and high deductible Plans. If you get injured or become sick out of New York State, you have access to their national network through Cigna PPO.

Oscar Health Insurance

Oscar came into existence in 2014 because of the Affordable Care Act and offers individual health plans on and off the exchanges. They have a wide variety of health plans to choose from but their primary coverage area is New York City, Brooklyn, Queens, Bronx, Staten Island and certain areas in New Jersey.

Oscar Insurance is known for utilizing technology to reduce costs for patients and providers. They use state-of-the art methods that appeal to millennials and technology savvy consumers.
One unique approach is Oscar provides healthcare assistance for consumers through fitness monitoring devices and offers cash rebates to people who use them. They are unique in the fact that they provide an online cloud system of applications, billing, health history and treatments.

Final Thoughts About Where To Buy A Health Plan

Selecting an individual health insurance policy can be confusing, so it’s important to compare your options and which plan designs will be best suited for you and your family. When comparing NY individual health plan options, don’t go it alone.

Utilize the expert services of an agent or broker like Healthplansny to help you find a plan that is right for you. There is no charge or additional fees to get quality advice. Remember that you must select a plan by December 15 coverage to be effective on January 1.