Best Health Insurance Plans in New York

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Compare Health Insurance Plans in New York

The Empire State has towering skyscrapers, dreamy fall foliage, and something a bit more overlooked- extensive health care options. New York has the 15th best health care in the US with regards to access, quality, and overall public health.

Health Care Choices in New York

According to the New York Department of Financial Services, residents can get coverage through several options:

  1. Employer-provided
    1. From your employer
    2. Through your spouse's employer
    3. Through COBRA
  2. Individual or family plans
    1. Through New York's health care marketplace
    2. Directly from a health insurance company
  3. Government-assisted
    1. Medicare
    2. Medicaid

Where do most New Yorkers get their health insurance coverage?

New York Health Insurance Sources
Sources Percent
Employer-Provided 50%
Individual or family 7%
Medicaid 24%
Medicare 13%
Other Public Care 1%
Uninsured 6%
Source: Kaiser Family Foundation, Health Insurance Coverage of the Total Population

Six percent of New Yorkers are uninsured, meaning the state falls significantly below the nine percent national average of uninsured residents. That's good for policyholders, because a high rate of uninsured people leads to higher rates for insured people.

New York Health Insurance Costs and Rate Factors

On average, New Yorkers spend $9,788 on health care expenditures per year, about $1700 more than the national average. What determines the cost of health care in New York? Factors depend significantly on the individual, so costs vary person to person. Mainly, here's what insurers are looking at when pricing your policy:

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Body Mass Index

Statistically, numerous health problems stem from obesity. Because of this, insurers often review your
BMI before pricing your policy. A higher BMI can lead to higher premiums.

New York has a 25.5 percent obesity rate, meaning only six states have a lower obesity rate. Out of the many New York residents who use QuoteWizard to shop for health insurance, only 21 percent have a BMI in the obese range.

Tobacco Use

Smoking has harmful effects on you heart, lungs, and brain. If you're a smoker, you'll pay more for coverage because of these substantial risks. About 14.2 percent of New Yorkers are smokers, the ninth lowest rate in the country.

Age

Health care plans often cost three times as much for older people than for younger people. NY residents who used QuoteWizard to compare health insurance plans are, on average, 40 years old.

Plan Type

The more medical coverage you want, the higher your premiums will be. Marketplace plans are organized in metal tiers: bronze, silver, gold, and platinum. Each tier offers different coverage levels.

Curious about what you'll be paying for health insurance in the Empire State? Here are the average monthly premiums for a 40-year-old New Yorker in 2018:

New York Martketplace Plan Rates
Bronze Silver Gold
$403 $492 $581
Source: Kaiser Family Foundation, Change in Average Marketplace Premiums by Metal Tier

You may have noticed the significant jump in cost from a bronze plan to a gold plan. In New York, going from one end of the tier to the other is about a 44 percent increase in cost. This price leap could be worth it if you end up needing to use your insurance. Coverage from the bronze level will help you with 60 percent of costs, whereas a gold plan will cover 80 percent of costs.

The lowest level of coverage is a catastrophic plan. You may qualify for this coverage if you are under 30 or have other exemptions. However, the deductible is $7,150 for one of these plans. Even though it has low monthly premiums, a catastrophic plan may not save you money in the long run if you actually need to use your health insurance.

Location

Location is a bigger factor in deciding health insurance rates than many people think. Costs are dependent on the laws, regulations, and health care providers within your state.

Health care costs are also community-rated, meaning your costs are influenced by how many claims your neighbor files. If people in your area file claims at a higher rate, your premiums could spike.

Because of this, living a healthier state could keep your costs low. Good news, New Yorkers -- according to America's Health Rankings, New York is the tenth healthiest state.

 New York Health Insurance Companies

Where do New Yorkers get their health coverage? Residents have several options for providers offering individual and family plans in New York. Here are the top health insurance companies in NY:

Coverage options vary based on which county you live in. Check out insurer websites to find out what policies you qualify for. You should also visit the New York Marketplace for more options.

New York Health Insurance Laws

The Affordable Care Act limits what restrictions and exclusions insurance companies can use to price your policy.

New York has a Family Planning Benefit Program, which requires insurance providers to offer some coverage for the following services for families:

  • Pregnancy testing and counseling
  • Screening and treatment for sexually transmitted infections (STIs)
  • HIV counseling and testing
  • Most FDA approved birth control methods, devices, and supplies
  • Emergency contraception services and follow-up care
  • Transportation to family planning visits

Read the entire list on the New York State Department of Health website.

Medicare and Medicaid in New York

Medicare and Medicaid are government-funded health care programs that offer coverage for different groups of people. Medicare assists senior citizens, and Medicaid aids low-income families and children.

Medicare

Medicare offers care to people over the age of 65. Within the Medicare program, there are many types of coverage including types A, B, C, D, and supplemental coverage plans. There are also four types of Medicare Savings Programs in New York that you may qualify for:

Qualified Medicare Beneficiary Program (QMB)

  • Single person with a monthly income lower than $1,005
  • Couple with a monthly income lower than $1,354

Specified Low Income Medicare Beneficiary Program (SLIMB)

  • Single person with a monthly income lower than $1,206
  • Couple with a monthly income lower than $1,624

Qualified Individual (QI)

  • Single person with a monthly income lower than $1,357
  • Couple with a monthly income lower than $1,827

Qualified Disabled and Working Individual (QDWI)

  • Single person with a monthly income lower than $2,010
  • Couple with a monthly income lower than $2,727

Medicaid

New York has a program called Medicaid for residents who cannot afford medical coverage. These are the state's Medicaid financial requirements:

New York Medicaid Financial Requirements
Household Size Maximum Yearly Income
1 $15,800
2 $21,307
3 $26,813
4 $32,319
5 $37,825
6 $43,331
7 $48,851
8 $54,384

New York Office of the Insurance Commissioner

Website:
Homepage
Insurance Commissioner:
Maria T. Vullo
Insurance Hotline:
(800) 342 – 3736
Office Hours:
Monday - Friday
8:00 am to 5:00 pm
File a Consumer Insurance Complaint
Complaint Page

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