Fast Facts

NY State of Health is a new organized marketplace that will help people get health insurance coverage.

Through the Marketplace, New Yorkers can easily compare health insurance options and enroll in health insurance coverage through a website, over the phone, in-person or by mail.  Think of it as a new way to compare and buy health insurance similar to the way people can compare and buy lots of products today.  (Previously, it was called the New York Health Benefit Exchange.)

 

Individuals and small businesses will be able to use the Marketplace, which will help make health insurance affordable.

Tax credits are available to help eligible people purchase private coverage through the Marketplace.  Individuals and families can use the Marketplace to find out if they are eligible for free or low cost health insurance coverage through current New York State programs (like Child Health Plus or Medicaid).  If they are eligible, they also will be able to enroll in these programs through the Marketplace.  Small businesses that have 50 or fewer employees can use the Marketplace to offer health insurance coverage to their staff and may be eligible for tax credits for coverage purchased through the Marketplace.

 

Today nearly 2.7 million New Yorkers (about 16%) under age 65 do not have health insurance coverage.

Most uninsured are workers and their families who earn too much to qualify for public programs like Medicaid, but not enough to buy coverage on their own.

Source: Urban Institute, Health Insurance Policy Simulation Modeling, 2012.

 

Over 1 million New Yorkers will get health coverage through the Marketplace.

This includes 615,000 individuals and 450,000 small business employees.

Source: Urban Institute, Health Insurance Policy Simulation Modeling, 2012.

 

Open enrollment for NY State of Health begins in Fall 2013.

People will be able to start comparing and purchasing health insurance coverage through the Marketplace on October 1, 2013.

 

Coverage purchased through NY State of Health begins in early 2014.

The first date coverage can become effective is January 1, 2014.  For coverage that starts on January 1, individuals and families need to enroll in a health plan through the Marketplace by December 23, 2013.  Small businesses and their employees need to enroll in a health plan by November 29, 2013 for coverage to start on January 1, 2014.

 

New York is developing the Marketplace with federal grant money.

To date, New York has received over $368 million in federal grant money to develop the Marketplace.  New York is also participating in a grant program run by the non-profit Robert Wood Johnson Foundation that provides technical assistance to our state.

 

People with pre-existing conditions can get insurance through the Marketplace.

Starting in 2014, health insurance companies cannot discriminate by charging more or denying coverage to people with pre-existing conditions.  This applies to coverage purchased both through the Marketplace and outside the Marketplace.

 

NY State of Health will not affect Medicare coverage.

The Marketplace is intended to help New Yorkers who are not eligible for Medicare get health insurance coverage.