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When Is Open Enrollment For Health Insurance In New York

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When Is Open Enrollment For Health Insurance

Open Enrollment 2021

The national Open Enrollment Period when you can join a health insurance plan for 2021 is six weeks long lasting from November 1, 2020 to December 15, 2020. Until 2017, every other Open Enrollment Period weve had was two to four times longer. More states could challenge this little-known provision in Idaho, but theres not much time left.

Reminder: Due to the ongoing effects of the coronavirus, the federal government opened a Special Enrollment Period from February 15, 2021 through August 15, 2021.

Benefits Of Working With A Health Insurance Broker

TrueCoverage is a Certified Direct-Enrollment Partner of  We offer more affordable health insurance plans than any other resource in NY, and our unique technology quickly delivers the BEST VALUE insurance policies that address your needs. 

Like brokers in every state, TrueCoverage operates without bias. Our job is to find you the best health insurance options, regardless of the insurance carrier.  Brokers search for policies that best meet your needs. We are there for you throughout your contract. For example, if a dispute arises with your insurer, TrueCoverage steps in to help.   

TrueCoverage is familiar with your states unique insurance rules, and we understand the New York health insurance options from the largest carriers to the smaller specialty health insurers.

New Yorks Medicaid Cancer Treatment Program

New Yorks MCTP services are available to low-income residents with breast, cervical, colorectal, or prostate cancer. Generally, residents must be under 65, meet citizenship requirements, and not be enrolled in qualified coverage at the time of application. The states Department of Health Cancer Services Program oversees the application process.

Income limits vary. For example, the threshold for colorectal and prostate cancer is 250% of the FPL or up to $32,200 for a single adult in 2021.

Those who qualify get full Medicaid coverage for a specific amount of time tied to the type of cancer. Enrollees must recertify each year if treatment is still needed.

Medicare For New York Seniors And Younger Adults With Disabilities

Medicare is a federal health insurance program generally for people 65 and older. But younger adults with disabilities and certain illnesses also qualify.

New York has the fourth-highest number of Medicare recipients in the country. More than 3.6 million residents enrolled as of 2018.

Roughly 6 in 10 enrollees have Original Medicare from the federal government. The rest have private Medicare Advantage plans. Both options provide Part A hospital and Part B medical insurance. But Medicare Advantage offers extra benefits, such as Part D prescription drug coverage.

Private companies also sell individual Part D drug plans, which are often paired with Original Medicare. Nearly 1.5 million New Yorkers have a separate Part D plan as of 2018.

Original Medicare enrollees can also add a Medicare Supplement plan, known as Medigap. New York, like most states, offers 10 standard Medigap plans. Policies help pay for covered out-of-pocket expenses, including copayments, coinsurance, and deductibles. Many policies also pay for qualified emergency care you receive in a foreign country.

Open Enrollment On Ny Healthplan Marketplace Extended Through Jan 31 2021

NY State of Health Announces Open Enrollment Dates for ...

ALBANY, N.Y. – New York extended the enrollment period for people to sign up for health insurance in 2020 through the New York Healthplan Marketplace earlier in the year as record levels of New Yorkers found themselves without a job and healthcare. Open enrollment to obtain healthcare from the marketplace for 2021 began on November 1, it will remain open through January 31, 2021.

Premiums for 2020 enrollees will not rise for those enrolling in health care coverage for 2021, it said on the New York State of Health website.

New York has done more than any state to expand access to healthcare and make high-quality insurance available to everyone. And as we continue to fight COVID-19, making sure every New Yorker is insured and has access to quality healthcare has only become more critical. If you are not insured, make 2021 the year you change that, go online or call NY State of Health for assistance, said Governor Andrew Cuomo.

NY State of Health continues to serve as a safety net for consumers in need of coverage during the public health emergency and has seen enrollment levels increase to over 5.5 million people. As we look ahead to 2021, the plan choices are consistent with 2020 and we will continue to be available to help consumers enroll through both the Customer Service Center and enrollment assistors, who will be available by phone, said Commissioner of the New York State Department of Health Dr. Howard Zucker.

  • Capital District Physicians Health Plan
  • Emblem Health

How Can I Save Money On Health Insurance

Saving money on health insurance involves choosing the right health insurance policy for your needs at the cheapest available price. By selecting a plan that fits your needs, you will find that you can actually save money instead of just choosing the plan with the most affordable premium. Read more here.

Ny State Of Health Open Enrollment Period Begins Sunday

FILE This Jan. 23, 2020 file photo shows a patient receiving a flu vaccination in Mesquite, Texas.

ALBANY, N.Y. This Sunday, open enrollment for 2021 NY State of Health insurance plans will begin.

Gov. Andrew Cuomo encourages those who are currently enrolled in a health plan through NY State of Health to renew their coverage.

New York has done more than any state to expand access to healthcare and make high-quality insurance available to everyone, Gov. Cuomo said. And as we continue to fight COVID-19, making sure every New Yorker is insured and has access to quality healthcare has only become more critical. If you are not insured, make 2021 the year you change that, go online or call NY State of Health for assistance.

Alongside the State Department of Financial Services and New York State insurers, NY State of Health launched a special enrollment period this past February. It was extended through the end of 2020.

According to Cuomos office, NY State of Health expects to renew Qualified Health Plan coverage for nearly 200,000 households. Current enrollees, including those who enrolled during the special enrollment period, may begin renewing their coverage on November 16.

Once it begins, open enrollment will continue through January 31.

To enroll in a plan, call 1-855-355-5777, go to this site, or speak with an enrollment assistor.

Beware Of Skimpy Plans

In the marketplaces, all insurance plans need to provide comprehensive coverage, which includes payment for pre-existing conditions, major medical expenses like hospitalization and rehabilitation, mental health, maternity care and prescription drugs. Out-of-pocket costs for deductibles and co-payments for some plans can be high, but tax credits, assuming you qualify, can help. Insurers also sell A.C.A.-compliant plans outside of the marketplaces.

Shoppers need to be wary of insurance plans that dont comply with the A.C.A. and look too good to be true; some have much lower rates but do not provide comprehensive coverage. An online search can easily lead consumers to short-term, limited-duration plans that do not provide comprehensive coverage.

While these cheaper plans are legally allowed, some of them impose dollar limits when you need care, and others will cancel your policy if you have an illness or need surgery.

Consumers can protect themselves by staying on the marketplace sites, or making sure their plan is compliant with the A.C.A. Some non-A. C. A. plansmay use deceitful tactics to lure unwary consumers.

States struggle to keep a lid on deceptive websites because its like whack-a-mole: You shut down one bad operator and he pops up somewhere else, Ms. Corlette said.

The Coronavirus Pandemic Covid

New open enrollment for health insurance marketplace

COVID-19 is a hot topic health insurance issue in New York. If you lose your health insurance due to COVID-19 or your employer closed because of the Coronavirus, testing is available at no charge. The Families First Coronavirus Response Act , passed in March 2020, ensures that everyone can receive COVID-19 testing. You also qualify for an SEP .

See our 5 top Kentucky health insurance companies at the bottom of this page.

Ryan White And The Aids Drug Assistance Program

Ryan White Part B Resources

Website: 1-800-542-2437

The Ryan White HIV/AIDS Program is a federal program specifically for people living with HIV. It covers outpatient HIV care and treatment for those without health insurance and helps fill coverage gaps for those with insurance. The program may also be able to help with the cost of things like insurance premiums, cost-sharing, and the cost of medication.

The AIDS Drug Assistance Program is part of Ryan White. It helps covers the cost of HIV-related prescription medications for low- to moderate- income people who have limited or no prescription drug coverage. Many states also use ADAP funds to help clients pay for the cost of health insurance. Each state operates its own ADAP, including determining eligibility criteria and other program elements, such as formularies, resulting in significant variation across the country.

With the passage of the Affordable Care Act , there are now more options for individuals with HIV, and other pre-existing conditions, to obtain affordable health insurance than before, including buying coverage in the marketplace and through expanded Medicaid programs. Some services previously covered under Ryan White / ADAP may be replaced by insurance, which would also provide for broader health care.

Buying New York Health Insurance For Individuals Families And Self

The Empire State offers affordable private health insurance for individuals and families. If youre self-employed with no employees, you qualify as an individual. You can buy coverage through the Marketplace called New York State of Health. Plans are available in all four metal levels: bronze, silver, gold, and platinum. These are known as Qualified Health Plans.

Each metal plan pays a percentage of your covered healthcare costs ranging from 60% to 90%. For instance, bronze pays 60% and is usually the lowest-cost plan. Platinum pays 90% and is the most expensive plan.

All plans provide comprehensive coverage that includes essential health benefits, such as hospitalization, maternity care, prescription drug coverage, and free preventive services.

The Four Levels Of Insurance Plans To Chose From At The Ny State Of Health Marketplace

At the NY health marketplace, you have the option to choose from four tiers of health insurance plans:

  • Bronze level 60 percent coverage
  • Silver level 70 percent coverage
  • Gold level 80 percent coverage
  • Platinum level 90 percent coverage

Each level offers different premiums covering different levels of medical expenses. For example, the Bronze level plans have a lower premium than the Silver level plans, but the Bronze plans have higher out of pocket costs. The consumer makes up for those other costs through deductibles, co-pays, and/or coinsurance.

For each tier, there is a limit on out-of-pocket spending thats equal to the Health Savings Account current law limit. In 2021 that limit is $3,250 for an individual and$6,450 for a family.

If your annual income falls somewhere between 100 and 400 percent of the federal poverty line, then there will be an even lower cap on out of pocket expenses.

For example, if your income is:

  • 100-200% FPL: one-third of the HSA limits ;
  • 200-300% FPL: one-half of the HSA limits ;
  • 300-400% FPL: two-thirds of the HSA limits .

Find Cheap Health Insurance Quotes In New York

Health Insurance New York Open Enrollment

New Yorkers can purchase affordable health insurance through the state marketplace or through Medicaid if their household income falls below 138% of the federal poverty level.

The average cost of health insurance in New York is $701, which is about 1% more expensive than it was in 2020.

To help you find the best coverage, we analyzed Silver health insurance policies available across all counties and found that the Fidelis Care, Silver, was the cheapest plan available. However, there are many insurers offering health plans in New York, and where you live will determine available companies and policies.

Which The Other States Can Still Extend Their Health Insurance Open Enrollment Period

Health insurance open enrollment extensions for Obamacare could be seen as a partisan issue, with Democrats in favor of longer enrollment periods and Republicans against them. However, open enrollment benefits are popular enough for very fine folks on all sides to have embraced them in the past.

Not every state can change the dates for the upcoming open enrollment for health insurance. These four states run their own exchange and can push back open enrollment:

States can extend open enrollment at any time, even once its already underway. For instance, Maryland waited until the last day it could to extend its open enrollment.

New York Exchange Overview

New York has fully embraced the Affordable Care Act, with a state-run exchange, expanded Medicaid, and a Basic Health Program. The state-run exchange is called New York State of Health. It is one of the most robust exchanges in the country, with 15 carriers offering individual market plans for 2021 .

There are also 14 insurers offering Essential Plan coverage in 2021 , and 14 insurers offering small business plans through NY State of Healths SHOP exchange .

Ny Expands Tax Credits Lowers Health Insurance Premiums For Residents

Deandre Gutierrez | Contributing Photographer

More New York residents will be eligible for financial assistance and lower health insurance premiums as part of a federal stimulus package, Gov. Andrew Cuomo announced in late March.

Residents will have access to expanded tax credits through New Yorks health plan marketplace, NY State of Health, Cuomo announced in a press release. The credits and reduced premiums are a product of the American Rescue Plan, which President Joe Biden signed into law on March 11. 

Biden first announced the plan to combat widespread economic insecurity as a result of the pandemic. In addition to the expansion of tax credits, the plan covers a wide variety of other measures, such as stimulus payments to individual citizens and financial support for colleges and universities. 

Heres a breakdown of how the American Rescue Plan will impact health insurance in New York state:

What Are My Coverage Options If I Miss The Open Enrollment Period

NY State of Health: Qualifying for Special Enrollment Periods

Unfortunately, you cannot enroll in major medicalinsurance if you miss the New York open enrollment period or if you do notqualify for a special enrollment period. However, you can get coverage throughother government programs that do not have an open enrollment period.

Programs such as Medicaid and CHIP do not have an open enrollment period. If you qualify youcan enroll any time throughout the year. You msut keep in mind that in order toqualify for Medicaid or CHIP you must meet an income requirement. Typically youneed to make below 133% of the federal poverty line to qualify.

If you are pregnant, disabled, or otherwise medicallyneedy but think you dont meet the income requirement, you should apply forMedicaid anyway; you may get accepted.

Cuomo Announces Open Enrollment For New Yorkers Now Extended Until March 31st

New Yorkers Can Apply Now for Coverage Through NY State of Health or Directly Through InsurersAmid Global Pandemic, High-Quality Health Insurance More Important Than Ever

As part of New Yorks ongoing response to the COVID-19 pandemic, Governor Andrew M. Cuomo today announced that the Open Enrollment Period for uninsured New Yorkers will be extended through March 31, 2021. New Yorkers can apply for coverage through NY State of Health, New Yorks Official Health Plan Marketplace, or directly through insurers.

Ensuring all New Yorkers have access to health insurance is essential, not only as we continue to fight the war against COVID, but to foster healthier, more resilient and more equitable communities as we rebuild post-pandemic, Governor Cuomo said. By extending this deadline until March, New Yorkers who need health coverage will have additional time to enroll and find the plan that works best for themselves and their families. 

Extending the Open Enrollment Period to March 31, 2021 helps to align New York with the federal Public Health Emergency which was recently extended to April 20, 2021. This extension allows individuals eligible for Qualified Health Plan insurance additional time to enroll for coverage in 2021 and means that enrollment remains open for all NY State of Health programs, which is especially important during the ongoing public health emergency. Coverage start dates will vary:

Will I Need To Get A New Doctor

That depends. Major insurance providers, including Empire Blue Cross and UnitedHealthcare of New York, offer New York State of Health plans, but not all doctors accept them. You can talk to your primary care physician or use the New York State of Healths comparison tool to see whether a certain doctor or practice will accept a marketplace plan. 

Contact The New York Exchange

About our health insurance quote forms and phone lines

We do not sell insurance products, but this form will connect you with partners of who do sell insurance products. You may submit your information through this form, or call to speak directly with licensed enrollers who will provide advice specific to your situation. Read about your data and privacy.

The mission of and its editorial team is to provide information and resources that help American consumers make informed choices about buying and keeping health coverage. We are nationally recognized experts on the Affordable Care Act and state health insurance exchanges/marketplaces. Learn more about us.

If you have questions or comments on this service, please contact us.

If You Like Your Current Health Insurance You Can Keep It


If you were already insured on March 23, 2010, when the Affordable Care Plan was signed into law or you are currently enrolled in a plan that existed before the ACAs signing, then your plan is eligible to be grandfathered in. That means you will be able to keep your current plan as is.

Please note though that some insurance companies or employers may choose not to grandfather in some of their health insurance plans.

If your current plan is not eligible to be grandfathered in or if it is discontinued, you should receive notice from your insurance company.

For the correct information, make sure to check with your employer or health insurance company.

New York Individual Health Insurance Plans Overview

You can purchase health insurance in New York through the NY State of Health marketplace. Health insurance in New York is one of the most heavily regulated in the United States. While the federal Affordable Care Act limits how insurers can price their policies, New York’s regulations are even more restrictive.

For both individual plans and small-business plans, all consumers living in a specific location pay the same price for health insurance. This means younger New York residents pay more for health coverage than they would in other states, while older residents pay less than they would in other states.

Open enrollment in New York begins Nov. 1 and continues through Jan. 31.

If you are a first-time buyer, then you can purchase a health insurance plan once enrollment opens, while people who are renewing a plan can do so beginning Nov. 16. If you buy a health plan before Dec. 15, then your effective coverage will begin Jan. 1. New York’s exchange portal also lists brokers who can provide guidance and help you enroll in a health plan.

Am I Going To Get A Tax Break To Help Pay For My Health Insurance

Maybe. If your income falls between 138 and 400 percent of the Federal Poverty Line you will receive credit paid directly to your insurer to help offset the cost of health insurance. It should also be added that these tax credits will only be available to those purchasing health insurance through the health care exchange and those who qualified for the subsidy.

The credit will be set up on a sliding scale so the lower your income the bigger your tax credit.

The History Of Health Insurance In New York State

New York State has one of the countrys most progressive health insurance systems. Since 1990, New York State residents have enjoyed the benefits of community rating and guaranteed issue. These two laws are key components of the Affordable Care Act that went into effect on March 23rd, 2010.

Respectively community rating and guaranteed issue mean insurance companies cannot charge people more based on their background or medical history, and deny health insurance coverage to anyone for any reason.

These two laws have expanded health insurance coverage to many New Yorkers since their introduction more than 20 years ago. However, these two policies have also contributed to higher health insurance costs in the state.

Before the Affordable Care Act being enacted and allowing these two laws to now become a right for Americans, some experts thought health insurance rates nationwide would increase. By some estimates, premiums were said to rise by as much as 30 percent, according to a study released by the Society of Actuaries.

In New York. however, it was thought that health insurance rates could fall by as much as 14 percent when the rest of the Care Act was to take effect, according to the same study.

Again, before the Affordable Care Act, states that already have community rating and/or guaranteed issue laws on the books like Maine, Vermont, Massachusetts, and New Jersey thought theyd also see the same cost declining effect.

How Much Does The New York State Benefit Exchange Insurance Plan Cost

Health Insurance Enrollment

Health insurance plans sold through the New York State Health Benefit Exchange have risen steadily since the creation of the NYSOH. Original estimates expected health insurance rates to fall. Unfortunately due to several factors, rates have increased annually. The major factors attributed to rate increase are

  • Less carrier competition in the marketplace
  • a greater pool of unhealthy insureds
  • younger people not signing up for insurance as anticipated
  • Congress removing promised risk optimization funding to insureds

A Culture Of Consumer Protections And Health Care Reform

Over the years, New York has implemented various regulations to enhance consumer protections, including

  • Not allowing grandmothered/transitional plans or short-term plans,
  • Surprise balance billing protections,
  • Extending the definition of small group to groups with up to 100 employees
  • Not allowing premiums in the small group and individual market to vary based on age or tobacco use.
  • Starting in 2018, broker commissions on all individual and small-group plans in New York had to be capped at no more than 4 percent of premiums. This was already the case for HMOs in New York, but New York also notified insurers that broker commissions above 4 percent for individual and small group plans would be deemed unreasonable .

New Yorks Assembly has passed several bills over the years that would create a single-payer system in the state, but none of the bills have survived in the Senate. The 2019/2020 legislation is A.5248 and S.3577, although neither advanced out of committee.

Exploring The New York Health Insurance Marketplace

New York residents can sign up for health insurance using private insurance exchanges. These marketplaces offer more choice of ACA-compliant plans than the state exchange. 

With Health Insurance Exchanges like TrueCoverage, you gain access to ancillary insurance such as: 

  • Dental
  • Medicare Advantage, Medicare Supplemental

Csr Funding And Its Impact On The Essential Plan

BHPs receive federal funding equal to 95 percent of the amount that the federal government would otherwise have spent on premium subsidies and cost-sharing reductions  in the state, if the BHP hadnt been available to consumers. In October 2017, the federal government eliminated funding for CSR, nationwide. Insurers still have to provide CSR benefits to eligible enrollees, but instead of getting federal funds to cover the cost, insurers have instead added the cost to premiums in nearly every state.

In New York and Minnesota, however, insurers didnt have to add as much to their premiums to cover the cost of CSR, because very few people receive CSR benefits in those states, and the CSR benefits that are provided are very small. Thats because nearly everyone who would have been eligible for CSR in those states is eligible for BHP coverage instead. You can see how this devolves into circular logic

Fortunately for New York and Minnesota, the judge ruled in May 2018 that HHS had to pay up. The ruling called for $169 million to be paid to New York and Minnesota for the second quarter of 2018 , and for HHS to work together with the states to sort out a payment formula going forward.

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