A.G. Schneiderman Reminds New Yorkers That New York State's Health Marketplace Opens November 1St For 2018 Health Plans

Schneiderman Also Offers Tips To Help Consumers Compare Health Care Plans In Advance Of NYS Marketplace Open Enrollment For 2018

  Attorney General Eric T. Schneiderman today reminded New Yorkers that open enrollment for 2018 health coverage begins on November 1, 2017 through New York State’s health insurance marketplace — New York State of Health. In advance of the open enrollment period, Attorney General Schneiderman issued an updated brochure, “Shopping For Health Insurance,” that offers tips for New Yorkers buying health insurance coverage – both on and off the Marketplace. The Attorney General also encouraged consumers to take advantage of the open enrollment period to evaluate how their current health plan has met their needs, to evaluate whether their current health plan will change in a way that impacts the benefits they expect to use, and to consider what other options are available.   

“Choosing a health plan is an incredibly important decision. The ACA is still the law — and New Yorkers should know they can enroll starting November 1^st to find the right coverage for their needs,” said Attorney General Schneiderman. “Exploring the New York Marketplace is a great way to start making health care enrollment decisions by comparing plans and analyzing costs to learn what options are available starting November 1^st.”

Open enrollment through New York State of Health begins on November 1, 2017. New Yorkers seeking coverage effective January 1, 2018 must enroll by December 15, 2017. Open Enrollment through the Marketplace ends on January 31, 2018. This is later than the open enrollment period available through healthcare.gov for states that rely on the federal marketplace to enroll in coverage. Enrollments or changes made between January 16 and January 31 take effect on March 1, 2018.

Once open enrollment for the Marketplace begins, New Yorkers will be able to review all available health insurance plans, as well as determine what premium subsidy you may be eligible for to reduce the cost of your monthly premiums. Coverage is also available outside of the Marketplace – but take note that those plans may have different enrollment deadlines. Premium subsidies are not available for plans purchased outside the Marketplace.

Attorney General Schneiderman’s brochure offers important information for all New Yorkers shopping for health insurance – whether they are considering purchasing health coverage for the first time, re-enrolling in their existing plan, or switching into a new health plan. Prior to enrolling, take some time to identify your health needs for the upcoming year, consider your budget, and compare the available plans to evaluate how they will satisfy your health and budget needs.

The Attorney General’s Office encourages all New Yorkers, when shopping for health insurance, to:

(1) Determine whether a premium subsidy is available through the Marketplace to make coverage more affordable (such subsidies are only available through the Marketplace);

(2) Check and confirm your provider’s participation status within the health plan, using the steps set out in the brochure;

(3) If you take prescription medications, check whether they are included in the health plan’s formulary, what your out-of-pocket expense will be, and whether there any pre-authorization requirements; and

(4) Check what the co-payment or co-insurance will be for any medical services you expect to use during the plan year, such as physical therapy or mental health services. 

Enrollment in Medicaid, Child Health Plus, and the Essential Plan is open year-round. This means that if you are (or become) eligible for one of these programs during the course of the year, you can enroll at any time. These programs offer low-cost, comprehensive health insurance coverage to lower-income New Yorkers. Child Health Plus is a New York State insurance plan for children, and children who are not eligible for Medicaid may be eligible to enroll in Child Health Plus. The Essential Plan offers coverage for up to $20 per month for lower-income individuals who do not qualify for Medicaid or Child Health Plus. 

To learn more about these programs and the qualifications for enrollment, please visit these websites:

• Medicaid: https://www.health.NY.gov/health_care/medicaid/
• Child-Health Plus: https://www.health.NY.gov/health_care/child_health_plus/
• Essential Plan: http://info.nystateofhealth.NY.gov/EssentialPlan

If you have any questions about a health plan’s coverage – including whether your provider is participating – you should call the insurance company directly and take detailed notes, including when you called, the name of the person with whom you spoke, what you discussed, and what you were advised.

If you encounter inaccurate provider listings once you are enrolled in a plan and cannot access needed care from that provider, or believe you were given inaccurate information during open enrollment, contact the Attorney General’s Health Care Bureau Helpline for assistance: 1-800-428-9071.

For questions about the New York State of Health Marketplace, contact the Marketplace directly: 1-855-355-5777.