New York Health Insurance

Looking for the right health insurance to fit your needs can be a bit tricky. To help you in your search, we've compiled some information about medical coverage in New York. After you've familiarized yourself with these facts, let us help you get a quote for the type of coverage you're looking for.

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Obtaining Individual Health Coverage in New York (NY)

Looking for health insurance for an individual in New York? The two types of policies available to you are group policies and individual policies. Individual health insurers can give you a more customized plan. Group networks, such as an HMO, PPO, POS, or HSA, have more restrictions but have the benefit of costing less.

Either way, you should educate yourself about the regulations in New York that will affect the type of plan you purchase. Below are a few such laws:

• Health insurance carriers may not refuse to cover you due to a health problem.
• In New York, individual insurers must also offer family coverage.
• If you have a preexisting condition, the maximum exclusion period you can be given is 12 months. Elimination riders cannot be attached to your policy.
• The past 6 months of your medical history are open to review by health carriers.
• Pregnancy is considered a preexisting condition in New York, but the exclusion period for pregnancy is a maximum of 10 months.
• Community ratings determine health insurance premiums.

New York Families' Health Insurance Options (NY)

If you are looking for health insurance for your family in New York, you have the same basic plans to choose from – an individual plan specific to your family's needs, or a group network such as an HMO or PPO for example. There are specific statewide regulations dealing with medical coverage in NY, however, so be sure to read up on the following:

• Nondiscrimination — If your family is qualified for group health insurance, you cannot be refused coverage, nor charged a higher rate because of a health condition.
• Special conditions for children — In New York, newborn, adopted, and disabled children, along with full-time students, are given special considerations when it comes to medical coverage. Check with the NY Dept. of Insurance for more information.
• Family changes — If your family has recent gone through a change, such as marriage or divorce, a birth, or an adoption, you may have extra opportunities to acquire family health coverage.

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New York Health Insurance and Pre-Existing Conditions (NY)

The Health Insurance Portability and Accountability Act (HPIAA) provides a way for people with preexisting conditions to shorten the waiting period required for health insurance. Preexisting conditions, under New York law, are any condition which requires a normally-healthy individual to seek medical treatment, diagnosis, or care within a two year period prior to the beginning of coverage. The waiting period cannot exceed 12 months and must be implemented for the condition and not the cause of the condition.

Healthy NY is a program that offers affordable health insurance to small business owners and individual workers whose employers do not offer health insurance. To qualify you must be unable to get Medicare or employer health insurance or if you have preexisting conditions that prevent you from having group health insurance by other means. You must also fall into a certain income bracket and have worked or had a working spouse in the last 12 months.

Discount health programs and fraud are a problem in New York. The New York Department of Insurance has investigated advertisements run in the state of New York claiming they can offer family health insurance for a much lower low price. Beware that these plans do not pay medical benefits and the provider may stop participating in the program at will. It is especially a problem for the elderly and people with chronic illness or preexisting conditions.

It is always wise to contact the New York Department of Insurance to find out the latest insurance scams and to verify the credibility of a health insurance company you are considering for your health care needs. This information is available to you for free.

Switching Your Health Plan in New York (NY)

Acquiring a medical plan is difficult enough, but if you've just switched jobs or recently moved to New York, you have another set of issues to deal with. If this is the case for you, take a look at the information we've collected for you:

• Your new employer may give you a waiting period before your benefits begin to take effect. If your employer uses an HMO plan, you may have an affiliation period.
• Employers in New York do not have to provide health insurance for their workers, so make sure yours does, or start searching for alternatives.
• If you've had a break in coverage for over 63 days, and have a preexisting condition, you could be subject to another exclusion period for your new health plan.
• If you'd like to keep the health plan you held under your previous employer, COBRA, a federal program, can help you to do so.

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