Need health insurance? A guide to getting insured through the ACA in New York State


Open enrollment for health insurance under the Affordable Care Act begins on Nov. 1. For most of the country, the sign-up window has been shortened this year, from three months to six weeks. New Yorkers, however, have until January 31, 2018 to enroll in, or renew an existing policy.

While President Trump and Republicans in Congress have spent much of the past year spinning their wheels and trying to repeal, replace and reform the ACA, also known as Obamacare, it is alive and mostly well, and ready to help you find coverage. If you don’t have health insurance there are lots of reasons to sign up–you’ll avoid the tax penalties that come from going uninsured, you’ll have access to preventative care and a safety net should major medical issues arise, and, if you’re into this sort of thing, signing up right now would be a real thumb in the eye to the administration and Washington Republicans.

It’s true, the sign-up process can seem daunting, and it may appear as though there are no affordable options out there for you.  Read on for some ways to make the whole thing easier.

Here in New York, we’re lucky to have a state government that has vigorously supported the ACA, and worked to expand healthcare access in general. Governor Andrew Cuomo has made it clear that  he believes that repealing the ACA would hurt New Yorkers, and the state’s untouched open enrollment period reflects his support for the law. “As Governor Cuomo has repeatedly stated, a repeal of the Affordable Care Act would have a devastating impact to New York’s health care system and its residents,” said spokesperson Jill Montag in an email. “The Affordable Care Act helped expand access to affordable healthcare to millions of New Yorkers.”

If you’ve decided to buy insurance through the New York State exchange, New York State of Health, the best way to get the best coverage for your needs, while making sure that you’re getting any subsidies you’re eligible for, is to go through a navigator; you can find one near you on this list. It is possible to sign up online without speaking to anyone, but it’s a long process, and especially if you’re a freelancer with variable income, a navigator is going to help you get the best possible deal for your money. You can also then call that person if you say, experience a sharp drop in income or get hired at a new job or have a baby, and they will help you adjust your coverage accordingly.

Navigators will let you know what information you need to bring to the appointment (plan on bringing a copy of your 2016 taxes, for sure), will guide you through the application process and answer all your questions about specific plans and plan features like deductibles, co-insurance and maximum out of pocket costs. They’re really a key resource.

The Community Service Society is one of the many organizations that provides navigators to New Yorkers, and leadership within CSS says that residents can feel confident in continued coverage, since New York State operates its own insurance marketplace and funds its own consumer assistance program.

“Those factors and NY’s expansion of Medicaid under the ACA have helped bring down the state’s uninsured rate to the lowest it’s been in decades,” said Jeffrey Maclin, a spokesperson for CSS, in an email.


In addition to medical coverage, you can also sign up for a dental plan through New York State of Health, if, for example you get medical, but not dental insurance through work. There are also resources for small businesses looking to insure their employees.

Here are some tips and useful links for finding and choosing an insurance in time during this year’s open enrollment period:

Find a navigator here, for individuals and families.

• To look at the list of insurers for both healthcare plans and dental plans, check out this Department of Health press release. If you’d like to search for healthcare coverage by plan or by provider, use this look-up tool.

• There is a tool on the New York State of Health home page for individuals and families that allows you to estimate the amount of financial assistance you’ll receive, without having to create a log-in and ID for the entire system. This can give you an idea of how much coverage will cost, but even if it’s more expensive than you anticipate, it’s worth consulting a navigator as well, especially if you are self-employed.

• You can search for resources for businesses, dental, and medical coverage via map, as well.

• Low-income New Yorkers may be eligible for the Essential Plan, which offers low cost preventative care for $20 a month, which is open enrollment throughout the entire year, if you qualify.

• If you need to insure a child outside of a family plan, or you can’t find a family plan you can afford and choose to insure just your children, Child Health Plus is open enrollment all year and is priced based on family income.

• The ACA mandates that most U.S. citizens must carry health insurance, either through their job, a state or federal exchange or another program, and tax penalties apply for anyone who goes without it. There are, however, special circumstances that will waive the penalty.

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