Your Guide To Health Insurance In New York: Options, Costs And Resources
With all the stresses of your day-to-day life, the last thing you want to have to worry about is facing monetary issues when a medical emergency arises.
That’s why having an adequate health insurance plan and access to healthcare is of the utmost importance. Luckily for all of you in the Big Apple, New York has a few options that will provide you with the financial security you need. Resources such as ours will help you navigate your options.
We know it can be tricky when it comes to deciding on health insurance, especially in a place like New York, and that is why we’ve put together the only comprehensive guide you’ll ever need.
Types Of Health Insurance Plans In New York
Understanding the different types of health insurance plans can be tough, so we’re going to simplify it for you.
Firstly, we have individual and family health insurance plans.
These plans refer to schemes that are funded by the member of the health insurance, in other words, you. It differs from schemes that involve government support as we will detail below. These plans tend to provide cover for but not limited to doctor’s visits, overnight stays in the hospital, and medication for prescriptions and ailments.
Private health insurance tends to cover a wider scope than public health insurance with access to private aid.
Secondly, we have employer-sponsored health insurance.
This refers to a scheme in which one’s employer contributes towards the monthly payment of the employee’s health insurance plan. These plans, aim to pay back employees for the medical expenses they fund on their own. The employer covers the bulk of the monthly premium, with the employee usually making a payment through a deduction.
Last but certainly not least, we have government-supported programs.
Two forms of this are Medicare and Medicaid. Medicare is available to persons 65 and older or young persons with disabilities. Medicaid assists individuals with extremely low incomes in having access to public hospitals.
Essential plan is another option afforded to persons who are in the workforce but earn a low income and do not qualify for Medicaid.
Understanding Health Insurance Components
We understand that sometimes the terminology used in health insurance can catch you off guard, so here are some fundamental terms to know going forward:
- Premiums – this is the amount that is paid to the healthcare provider to keep your policy going.
- Deductibles – this is the amount that you as the individual pay on your own prior to the health plan paying.
- Copayments – this is a fixed amount that you pay for each healthcare service. It is required by the healthcare provider that you make this payment for healthcare services that are covered.
- Out-of-pocket maximums – this a limit that is placed on the monetary amount you must pay for healthcare services.
Outside of the basic terminology, it is also important to understand the significance of in-network versus out-of-network providers.
In-network providers are healthcare providers who fall within your plan, while out-of-network providers fall outside of it. Attending in-network providers is far more cost-effective as they can only charge you the rate agreed upon under your healthcare plan.
How To Choose The Right Health Insurance Plan
Choosing the right health insurance plan can be tough, to pick the right one, you need to take into account your or your family’s needs, the fees involved, and the coverage the plan provides.
Finding the right health insurance plan doesn’t have to be done on your own however, you could make use of a health insurance broker in New York, who will know what to look out for to cover your best interests.
Enrollment Information
You’ll have to be aware of enrolment periods, as you don’t want to miss the deadlines for these.
Open enrolment is a time frame usually between 1 November and 15 January which outlines a period in which you are able to enter into, alter, or terminate your healthcare plan. Special enrolment refers to a time period that exists outside of the open enrolment timeframe. It is paramount that you don’t miss these deadlines, as it could result in you not having adequate coverage for yourself and your family.
On top of that, you could even be liable for a fine.
Navigating The New York Health Insurance Marketplace
Whether it’s free health insurance in New York or a plan with full coverage, navigating the marketplace can be difficult. You can access it by enrolling online or discussing it with a broker who can assist you.
Enrolling is a process whereby you need to choose your plan, make any extra information available, and lastly confirm your enrolment.
Common Questions And Answers
A number of common questions arise when dealing with health insurance and we’re here to help you answer them.
Firstly, if you miss the enrolment period you should look at the deadlines for special enrolment or explore taking up short-term plans until enrolment reopens. Secondly, if you want to switch plans and providers, you can do so by expressly canceling the previous plan which is usually done in writing, and then entering into a new plan.
Lastly, the steps you can take to appeal a denied claim are to start off with ascertaining why the claim was not accepted and make contact with the relevant providers. Once that is done, get your forms together and put together an appeal. If that is denied an external review may be the last-gasp effort to get it accepted.
As always we encourage you to explore the options available to you and seek out a health insurance broker to help you through the process if needed.
