Provides affordable health coverage to eligible individuals and sole proprietors
Eligibility
Are a New York State resident residing within our 28-county service area.
Your spouse is self-employed or employed on a full or part-time basis. If not employed at the time of the application, you or your spouse must have worked for some portion of the 52 weeks preceding the application.
Are not eligible for employer-provided comprehensive health insurance and have not had comprehensive health insurance (either individually or with a group) during the previous twelve months.
Medicaid, Family Health Plus, Healthy New York or Child Health Plus coverage with another health insurer is not considered comprehensive coverage for determining eligibility.
Qualifying exceptions to this requirement include:
Loss of employment
Change to a new employer
Loss of eligibility for group health insurance coverage
Change of residence
Discontinuation of a group health plan
Termination or cancellation of COBRA coverage
Legal separation, divorce or annulment
Death of a family member
Reaching the maximum age for dependent coverage
Have a total gross household income that meets the income guidelines for the program. The amount of the household income limit depends upon the number of household members you have. Click here to find out if your household income meets the Healthy New York income guidelines.
Effective January 1, 2012, new applicants may only choose the ‘High Deductible Health Plan’ option. Click here to find out more.
Are not eligible for Medicare
Benefits
Inpatient hospital services consisting of daily room and board, general nursing care and miscellaneous hospital services and supplies
Outpatient hospital services consisting of diagnostic and treatment services
Outpatient surgical facility charges related to a covered surgical procedure
Coverage for Home Health care for up to 40 post-hospital or post surgical visits in a calendar year
Coverage for 30 post-hospital or post-surgical visits per calendar year for physical therapy
Update: The Healthy NY High Deductible Health Plan (HDHP) 2013 deductible and annual out-of-pocket maximum have increased per federal guidelines. The deductible for Healthy NY HDHP increased to $1,250 for individual plans and $2,500 for family plans. The annual out-of-pocket maximum amounts for Healthy NY HDHP increased to $6,250 for individual plans and $12,500 for family plans.
Or contact customer service at 1-800-261-5962, Monday – Friday 8:30 a.m. – 5:00 p.m. EST for more information
A completed application received by the 20th of the month will be effective the first day of the following month. Healthy New York applications received after the 20th of the month will be effective the first day of the month after that
Cost
No payment is required with your application; a bill for the cost of your monthly premium will be mailed to you once you are enrolled.
