2019 Open Enrollment is Underway: A Q&A with NY State of Health

December 5, 2018

Open enrollment for health insurance in 2019 on the New York State marketplace is open. The Healthcare Education Project spoke with NY State of Health regarding key information you should know to sign up for healthcare.

Q: What makes NY State of Health unique, compared to the federal healthcare exchange that many states use?

  • NY State of Health is a one-stop shop for health insurance, both subsidized and unsubsidized. Consumers can compare many health plan options, check eligibility, apply for financial assistance, and enroll all in one place. This can be done online, in person or over the phone. NY State of Health was established by Executive Order in April of 2012 by Governor Andrew Cuomo
  • In NYS, we are proud to have a very stable marketplace: all 12 issuers offering Qualified Health Plans last year will offer them again in 2019 and we have 11 issuers participating in all Marketplace programs.  This level of plan participation ensures a robust set of plan options for New York consumers.
  • NY was one of two states to adopt the ACA’s low-cost Basic Health Program option, branded as the Essential Plan in NY. This program offers eligible consumers the same comprehensive coverage offered by all marketplace plans for $20 per month or nothing, no deductible and low cost sharing.
  • Additionally, New York’s Small Business Marketplace has expanded considerably due to significant changes. It’s now easier than ever for New York’s small businesses to access the Federal Small Business Health Care Tax Credit, and there are more health plans for employers to choose from through New York’s SBM. Eligible employers can access tax credits by completing a short application at ny.gov/employer and enrolling in Marketplace-certified plans directly with insurers of their choice. Previously, small businesses could access tax credits if they enrolled through the NY State of Health website and selected from a limited number of plans. Today, there are nine insurers offering more than 2,000 products through NY’s SBM.
  • Another major difference is NY State of Health’s longer Open Enrollment Period until January 31, 2019, for those needing to enroll in a Qualified Health Plan. Those who want coverage starting January 1, 2019, must enroll by December 15, 2018. Of course, those qualifying for public health insurance programs and the Essential Plan can enroll year round.

Q: How have enrollment numbers changed since 2017, and what is responsible for those changes?

  • In 2018, enrollment across all programs increased by nearly 700,000. NY State of Health has been very successful since its inception and enrollment has increased every year. Today, more than 4.3 million New Yorkers have enrolled in coverage.
  • Between 2017 and 2018, enrollment in Qualified Health Plans and the Essential Plan increased by 84,000 over the previous year, to nearly 1 million.

Q: What information do New Yorkers need to provide when signing up for healthcare through NY State of Health?

  • Certain basic information such as name, address, phone number, and a social security number or document numbers for legal immigrants are needed when applying for coverage.
  • Employer and income information for everyone in the family/household seeking coverage is also needed. Those who have access to other health insurance coverage (including job sponsored health insurance), must state this as well; it’s recommended to bring policy numbers for any current coverage. 

Q: How does one choose a plan best suited to one’s needs?

  • To help consumers select the plan that’s best for them, they should think about their coverage needs. They may wish to consider the following questions:
    • What kind of medical services they need?
    • Are there prescription drugs that I take?
    • Are there doctors and other healthcare providers or healthcare facilities that I prefer?

Q: How does one contact NY State of Health? What support do you provide during the enrollment process? 

  • New Yorkers can connect with NY State of Health in three ways.
  • Call the Customer Service Center at 1-855-355-5777 Mon-Fri from 8am to 8pm and Saturdays from 9am to 1pm to get help with questions and to enroll in a plan.
  • Meet with one of many certified in-person assistors who are available in every county of the state providing free enrollment assistance in nearly 40 languages.
  • Visit ny.gov to access educational resources (including print materials in 27 languages), a cost estimator, a provider look-up tool and a searchable directory to find a local enrollment assistor.