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Information for New York

Health Insurance Plans in New York

Whether you use your health insurance plan a lot or just for check-ups, you can find the right one with Empire. You’ll find special programs, great doctors, and plans that fit you just right. So you can get healthy and stay healthy. Let’s check out all your health insurance options so you can find the best one for you or your family.

Open enrollment is closed.

It reopens on November 1, 2017. You can still apply for dental insurance or dental with vision insurance. Or find out if you qualify for a Special Enrollment Period for certain life events like getting married, having a baby or moving to a new area. In most cases, you’ll have a limited time to make a change to your health insurance after one of these events.

 
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Which health insurance plan is right for you?

Health insurance plans come in all shapes and sizes. At Empire, our plans come in a range of prices, too, so you’ll find the right fit for your wallet.

Over 65 or Medicare eligible? Check out our Medicare Plans

Pick your plan level

Everyone’s budgets and health care needs are different. So we designed our plans that way. They come in different price levels: Bronze, Silver, Gold, or Platinum. They can be simple and affordable or broad and comprehensive. Whether you’re a family of five with lots of doctor’s appointments or someone who just wants to be covered for emergencies, we’ve got a health plan in New York to help match your needs. Learn more and explore your options below.

Bronze! On this health plan, you’ll have low monthly payments while being covered for check-ups and preventive care. You could pay more out of pocket if you need more care, but if you don’t expect to go the doctor very much this year, Bronze is a good bet. These health plans can be great for people who are younger with no dependents.

Silver! On this plan, you’ll get affordable health insurance that covers all the basics and more. You’ll still have low monthly payments, but you’ll spend a little more out-of-pocket if you need to visit the hospital or a specialist. You’ll also get preventive care for $0 with no copay and no deductible. If you work hard to keep yourself in good health, Silver is a great option for your budget.

Gold! This is a good all-around health plan. You’ll have moderate monthly payments and lower out-of-pocket costs in the event of an illness or hospital visit. You’ll have a lower deductible to meet, and you can save on visits to doctor or specialists whenever you need them.

Platinum! On this plan, your monthly payments are higher, but you’re covered for emergencies, regular doctor visits, and preventive care alike, with little or no deductible. It’s broad coverage with out-of-pocket savings for individuals and families.

Cost





Monthly Premiums
Deductible
Out-of-Pocket

Find your best fit

Who are you insuring?

How often do you go to the doctor each year?

Based on the number of people you are insuring and how frequently you go to the doctor, we think you would be best suited with this plan.

How Expenses are Covered

When you have health insurance, we’re here to help with medical costs. As soon as you start the monthly payments on your plan, you’ll be covered for check-ups and preventive care. Most preventive care is free or costs a fee called a copay. For other care, you might be asked to pay for your care up to a certain amount. That’s reaching your deductible. Once you reach it, we’ll start paying for a big percentage of your costs. You just pay the rest. That’s called your coinsurance. Finally, every plan has an out-of-pocket limit that you can reach if you spend a lot in one year. 

Deductibles & Copays

When you have health insurance, we’re here to help with medical costs. As soon as you start the monthly payments on your plan, you’ll be covered for check-ups and preventive care. Most preventive care is free or costs a fee called a copay. For other care, you might be asked to pay for your care up to a certain amount. That’s reaching your deductible. Once you reach it, we’ll start paying for a big percentage of your costs. You just pay the rest. That’s called your coinsurance. Finally, every plan has an out-of-pocket limit that you can reach if you spend a lot in one year. 

Medical Expenses Over the Year

Deductible

The set amount you pay out-of-pocket each year before your plan starts paying for covered services, except for in-network preventive services. In-network preventive services are covered before the deductible is met.

Copays & Coinsurance

A copay is a fixed fee that you pay out-of-pocket for each visit to an in-network health care provider. Coinsurance is the amount you pay for covered health care services. It’s a percentage of the cost of services after the deductible has been paid.

Out-of-pocket limit

Once you have met your out-of-pocket limit, your plan pays 100% of the maximum allowed amount for covered services for the rest of that calendar year.

Can I get help paying for health insurance?

The Affordable Healthcare Act (ACA) gives lots of people help paying for their health insurance premiums. If you qualify, you’ll look for a plan on the health insurance Marketplace that fits your needs. Then, you can buy your plan right here with us. Find out if you might qualify.

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You’re eligible for help!

Based on your income and tax status, you may qualify for help from the federal government (in the form of a tax credit) that will help lower your monthly payments on your health insurance plan.

You’re likely not eligible.

Based on your income and tax status, you may not qualify for help from the federal government (in the form of a tax credit).

Learn more about the New York state Marketplace
New York state Marketplace

Other help programs

Minimum Coverage Plans

Minimum coverage plans help save money on health insurance for people with certain qualifications. If you’re under 30 or qualify for one of 14 hardship exemptions you may be eligible for this plan.

See if you qualify for a minimum coverage plan
Medicaid Eligibility

If you’re disabled, managing a chronic condition, or need income assistance, you may qualify for Medicaid coverage.

See if you qualify for a Medicaid plan*

Not eligible? See if you qualify for a subsidized plan