Will This Lead To Huge Waiting Lines For Care
American health insurance companies have a long history of trying to scare Americans away from universal healthcare by claiming that well be stuck with huge waiting lines. As evidence, they usually reference Canada, which has a very popular single-payer system that covers everyone, while spending only about half as much as the U.S.
First, its important to clarify that, as in Canada, there are NO waiting lists for emergency procedures. Its also important to bear in mind that waiting times are a part of every healthcare system. Although patients in some parts of Canada have reported longer wait times for certain non-emergency procedures, it seems to vary widely by province. In many parts of Canada, the waiting times are similar to those in the United States assuming you have insurance. Overall, the waiting time issue in Canada is much smaller than portrayed by American health insurance companies.
The New York Health Act will remove many of the sources of long wait times in the US. There will be no limited provider networks, and providers will no longer discriminate against Medicaid and Medicare patients, since reimbursement rates will be standardized. There will be no barriers to provider choice, creating a greater range of options, especially in urban areas with greater concentrations of providers.
I Currently Buy Obamacare Insurance
The legislation introduces additional subsidies meant to lower the amount most people pay for insurance purchased on Affordable Care Act marketplaces. These extra subsidies will be retroactive to Jan. 1. The details of how you will get this new discount depend on where you live. If you get your coverage from Healthcare.gov, you will need to go back to the website to request the extra discount. In some state-run marketplaces, such as the District of Columbia, prices will adjust automatically. Regardless, you will be eligible for a refund for any overpayments when you file your 2021 taxes.
To get an approximate sense of how much your premiums will decrease, these maps may be helpful. To know your new premium more precisely, try the Kaiser Family Foundations online calculator, available here or look at your options on Healthcare.gov.
The stimulus package funds these extra subsidies for two years. Any extension after 2022 will require new legislation.
If you already have Obamacare coverage, but you have received unemployment insurance any time this year, you now qualify for additional assistance. You should go back to the marketplace to make sure you are signed up for that extra benefit once it is set up.
Counselor Locations By Borough
Due to the COVID-19 pandemic, in-person health insurance enrollment services will be suspended until further notice.
During this period, you can call for information or to schedule a telephone enrollment appointment. Our enrollment staff will continue to help New Yorkers sign up for low- and no-cost health insurance by phone. Help is available regardless of immigration status, in many languages, and your information will be kept private.
- 1309 Fulton Avenue, Third Floor646-483-1279, 646-983-1712
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- 347-236-7029, 646-799-1346, 347-236-9934
Manhattan
- 600 West 168th Street, Second Floor
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New York Childrens Health Insurance Program
CHIP is called Child Health Plus in New York. Its available to uninsured children under 19 who dont qualify for Medicaid. About 682,000 children are enrolled as of October 2019.16 Families can apply for the program through the New York State of Health Marketplace.
Children must be New York residents from low-income households to qualify. Some families get Child Health Plus for free, while others pay a small monthly premium.
For example, a family of three earning at or below $2,843 per month can get coverage with no monthly premiums. If the same family made up to $3,947 per month, they would pay a $9 monthly premium per child or a maximum of $27 for all covered children. There are no copayments, regardless of income.
What If I Am On Medicare
Seniors on Medicare will benefit from expanded benefits from the NY Health plan, which will include vision, dental, hearing, and long-term care.
Medicare recipients currently spend an average of $6,100 or 22% of their income on health care. The New York Health Act will eliminate all out-of-pocket costs, ending financial worries when seeking health care. New Yorkers will pay less in New York Health taxes than they are paying now to insurance companies and in out-of-pocket expenses, and they will get the health care they need when they need it.
Learn more about Medicare and the NY Health Act here.
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Wont New York Health Be Just Like Every Other Health Plan Only Bigger
Not at all. By law, it will not limit who you can go to for care and will not dictate health care decisions. Financial barriers wont limit your ability to get care when you need it. Because wealthy and well-connected New Yorkers will be in the same plan with the rest of us, you can be sure it will be a better planbetter for patients and for health care providers.
American Disabilities Act Notice
In accordance with the requirements of the federal Americans with Disabilities Act of 1990 and Section 504 of the Rehabilitation Act of 1973 , UnitedHealthcare Insurance Company provides full and equal access to covered services and does not discriminate against qualified individuals with disabilities on the basis of disability in its services, programs, or activities.
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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.
How Will We Pay For The New York Health Act
Many people assume expanding coverage will mean a more expensive system. But the reality is that there is so much waste, fraud, and profiteering in the current system, that moving to a universal, single-payer model actually costs less than the status quo for both the state and 90% of individuals. Below is a graph that shows the funding sources, as well as estimated costs to individuals by income bracket for the NY Health Act. These are based on conservative estimates from the RAND Corporation that savings compared to the current system is $11 billion. The bottom line is that not only is it a moral imperative to guarantee everyone access to care as a right and public good, it is fiscally conservative. We simply cannot afford not to have a single-payer system.
For a deeper dive into the cost and savings of the system to the state and individuals,
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Health Insurance Special Enrollment Period
Apply for coverage through NY State of Health by phone at 855-355-5777, or directly to insurers. The special enrollment period for uninsured New Yorkers is open until December 31, 2021. If you lost employer coverage, you must apply within 60 days of losing coverage. Because of a loss of income, New Yorkers may also be eligible for Medicaid, the Essential Plan, subsidized Qualified Health Plans or Child Health Plus.
Do I Need Health Insurance If I Have An Hsa/fsa
Youre not required to have health insurance to have flexible spending accounts, which are only available through an employer who offers them. You must have a special type of health insurance called a High Deductible Health Plan to open health savings accounts. HSAs and FSAs both allow you to set aside pre-tax money, which can only be used to cover certain health care costs.
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How Do I Enroll In New York Individual And Families Insurance
When enrolling in a family plan, you must consider the needs of every family member enrolled. Financial assistance is based on your households combined income. Family size impacts your premium and deductibles. Enrolling in individual plans is more straightforward because you only have your own health needs and income to consider.
The three primary types of plans offered in New York include:
- Health Maintenance Organization plans typically cost less than other health coverage types and have some restrictions that can affect your ability to access care. For example, you may have to ask for a referral if you want to see a specialist and your network is local.
- Preferred Provider Organization plans dont require referrals and usually offer nationwide coverage but tend to cost more than HMO plans. Most PPOs also have out-of-network benefits.
- Exclusive Provider Organization plans will cover services received outside the network, but usually at a higher rate than in-network care.
I Need Insurance And I Am Collecting Unemployment Insurance Benefits
The stimulus bill provides substantial, short-term subsidies to buy coverage on the Obamacare marketplaces. Regardless of your income, if you collect unemployment insurance at any time this year, you will qualify for a free silver plan with special bonus coverage that will lower your deductible and co-payments.
It may take a few months for Healthcare.gov or your state exchange website to update. Healthcare.gov will be set up to administer these benefits on July 1. But if you sign up for a silver plan now, you will be able to get these benefits for the rest of the year. You may need to pay a higher premium at first while the system is adjusting, but you will eventually be eligible for a refund.
If you used to get insurance at work, you may also qualify for up to six months of free COBRA coverage, meaning you have a choice about which kind of free insurance you want.
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What Kind Of Low
Low-income residents of New York may qualify for Medicaid. Residents whose incomes are too high for Medicaid but too low to afford individual insurance may qualify for an Essential Plan for adults or Child Health Plus for children. There arent any set enrollment periods for any of these programs, so you can apply anytime.
Insurance For Individuals In New York
Before searching for coverage, think about what kinds of medical services you need. All plans on New Yorks marketplace must include 10 essential health benefits to guarantee coverage for doctor visits, emergency care, hospital stays, prescription drugs, and more. Preventive care, such as routine screenings, is free. You can also find plans with additional benefits, such as adult vision and dental coverage.
Health insurance plans in New York generally have four major plan levels called metal tiers and include bronze, silver, gold, and platinum. The higher the tier, the higher your premium, but the lower your cost-sharing.
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Insurance For Families In New York
Insurance plans for families work very similarly to individual plans. The type of plan you choose can have a greater effect on families, especially if someone in your household has a condition that requires ongoing care or a preferred doctor. Depending on how you need to cover your family members, each person may be on the same health plan or on different health plans within the same policy.
You still compare plans on the New York Health Insurance Marketplace, and plans all include 10 essential benefits and are divided into metal tiers. For families, note that required benefits include dental and vision coverage for children.
What Plans Are Available
New York State of Health plans are organized into four categories:
- Bronze plans have the lowest monthly premiums and the highest deductibles and copays and cover roughly 60 percent of care costs. Theyre designed to help you in case of serious illness or injury.
- Silver plans have moderate monthly premiums, deductibles and copays and cover roughly 70 percent of care costs. Theyre the only plans eligible for cost-sharing subsidies.
- Gold plans have higher monthly premiums and lower deductibles and copays and cover roughly 80 percent of care costs.
- Platinum plans have the highest monthly premiums and the lowest deductibles and copays and cover roughly 90 percent of care costs. These are for people who have significant health care needs and are willing to pay the highest premiums.
New York State of Healths comparison tool allows you to estimate costs and benefits of various plans and check whether you might qualify for financial assistance.
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Free Clinics For The Uninsured
The Institute for Family Health receives generous support from Robin Hood to operate two free clinics, one in the Bronx and one in Manhattan. The clinics provide comprehensive, high-quality health care to people who are uninsured. All services are free and confidential. The Free Clinics are open on Saturday mornings, except holidays. We offer:
- Medical care for adults
- Health education
- Counseling
- Social work services for adults
- Health insurance enrollment if you are eligible
The Free Clinics are operated in partnership with students from two of New Yorks premiere medical schools: New York University and Albert Einstein College of Medicine. Students are supervised at all times by senior Institute physicians. Free clinic services are only for adults. All children in New York State are eligible for Child Health Plus health insurance. You can make an appointment at any of our locations and we will help your child enroll in Child Health Plus. After two visits to a free clinic, we will begin to make appointments for you at our regular health center. Institute for Family Health centers accept all patients, even those without insurance. We offer discounted services based on your family income. You will not be turned away.
Pros And Cons Of Self
One change made by the Affordable Care Act is it now allows monthly premiums to be a deductible line item on a tax return for someone that is self-employed. It is also beneficial to be able to have the flexibility to change income levels, which may qualify you for subsidies to help with the cost of coverage. That being said, this can be a double-edged sword. If business circumstances change in the opposite direction and you find yourself doing better than you anticipated, you must remember to update your income and risk paying a higher amount in monthly premiums.
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What Is The New York Health Act
New York Health is legislation in New York State that would provide comprehensive, universal health coverage for every New York resident and worker, replacing existing private insurance company coverage. You and your health care providers work to keep you healthy. New York Health pays the bill. This plan is similar to Medicare or the Canadian system but better.
Instead of having to worry about getting health insurance through your job, spouse, or buying it on your own, all New Yorkers would automatically have their healthcare covered by a public statewide fund, regardless of age, employment, or financial means. Everyone would have access to healthcare the way everyone has access to the fire department, libraries, and schools public services provided without your ever having to worry about a bill.
Why Not Have A National System Why Should New York Be Doing This
It would be great to have truly universal coverage in every state. But Washington is heading in the opposite direction. A progressive state like New York can and should take the lead. The states have long been the laboratories of democracy, and the Affordable Care Act gives states new authority to set up their own health care systems that meet Federal goals. Our advocacy could help set the model for healthcare, inspiring other states and then Washington to follow. Canada’s system was set up in a province first before being adopted shortly after by the rest of the country.
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Medicaid Health Insurance Coverage In New York
New York’s Medicaid program is a form of health insurance for those who can’t pay for an individual plan. Qualifying for Medicaid is primarily a function of your income and household size. Through the state’s expansion of Medicaid, most households with modified adjusted gross incomes under 138% of the federal poverty level are eligible for Medicaid coverage in New York.
The income limits for children and pregnant women are slightly higher than those for adults. Children up to the age of 19 are eligible for a special type of Medicaid if the household income is under 154% of the FPL, while pregnant women and infants up to the age of 1 are eligible if the household earns less than 223% of the FPL.
The following table illustrates the maximum yearly income a family can have in order to qualify for the Medicaid thresholds in New York.
| Family size |
|---|
| $58,680 |