quick look: best health insurance in new york (ny)
- Best Overall: Fidelis Healthcare
- Best Catastrophic Plan: Empire Blue Cross
- Best Network: United Healthcare
- Most Affordable: Univera Healthcare
Health care costs continue to rise, making health insurance essential. You may not think you can afford health care if you live on a limited budget. however, thanks to the introduction of the Affordable Care Act, low-cost health insurance plans are easier to find than ever.
best health insurance providers in new york (ny)
Now that you understand how health insurance works, let’s take a look at some of the best health insurance plans in New York that offer affordable rates. Do your research and click through to each provider so you can find the cheapest health insurance in New York that offers the best value.
1. caring for fidelis
fidelis care can offer an affordable plan option if you need affordable health insurance in new york and qualify for both medicare and medicaid.
fidelis care’s dual advantage plan helps policyholders bridge the gap between medicare and medicaid seamlessly and with almost no out-of-pocket costs. that’s why it’s a great option for anyone with a disability or living on a fixed income.
fidelis care also offers some of the most affordable private plan options in new york, making it the best option for affordable health insurance in new york.
2. blue cross empire
You can often save money by choosing a catastrophic plan if you’re young and relatively healthy. empire bluecross offers comprehensive catastrophic plans, and their website makes it easy for you to see if you may qualify and get a quote.
empire bluecross is a fantastic resource if you want to save money and manage your health care on your own. empire can offer a wealth of information on everything from preventative treatments to scheduling care.
Plans are even available for as little as $49 per visit for the most basic coverage options.
3. united health
united healthcare could be the healthcare provider for you if you value expansive networks.
United’s affordable hmo plans include an impressive selection of care providers – it’s one of the largest health insurance providers in the country.
united healthcare also offers a number of plan options ranging from short-term gap coverage to medicaid options.
united healthcare combines affordability with a large network and is a leading provider of hmo plans and more.
4. universal health care
Another viable option for low-cost health insurance plans is Univera Healthcare, which offers individual, family and Medicare plans.
the essentials plan from univera healthcare includes premiums from $0 per month and additional discounts on deductibles for low-income families.
univera healthcare offers plans throughout new york state, so no matter where you are, chances are you can find an office near you. Plus, all Univera plans offer free preventive care, including immunizations, checkups and screenings.
average cost of health insurance in new york
The average person in a private health insurance plan pays about $484 each month for coverage. however, the specific amount you’ll pay depends on several factors, including your location, the people on your plan, and your deductible.
types of health coverage
There are several types of health insurance plans. Understanding the difference between each type of plan can help you select the best provider for your needs. Let’s take a look at 4 of the most common types of health insurance plans.
- Health Maintenance Organization (HMO) Plans: HMO plans require you to stay within the insurance company’s network of service providers. HMO plans give you the least amount of freedom in choosing the health care professionals you work with, but they also involve the least amount of paperwork. hmo plans are also often some of the cheapest plans.
- preferred provider organization (ppo) plan: just like an hmo plan, ppo plans include a network from preferred providers within the organization’s network. You can see doctors and specialists outside of your plan’s network, but you’ll pay an additional fee for the service. PPO plans require a little more paperwork if you visit a provider outside of their network, but you can get discounts if you visit health care providers in their network. ppo plans are more expensive than hmo plans.
- point-of-service (pos) plan: a pos plan is similar to a combination between an hmo and a ppo. pos plans allow you to see any primary care doctor you want. Similar to a PPO plan, you’ll save money if you choose an in-network provider, but you may pay more to see an out-of-network doctor. Unlike a PPO plan, you’ll need to get a referral to see a specialist from your primary care provider just like you would with an HMO. pos plans give you a little more freedom to choose providers and also keep costs lower than a ppo plan.
- catastrophic plan: you may be able to get a catastrophic plan if you are under 30 years old. catastrophic plans have high deductibles, but you’ll get 3 primary care visits before the deductible applies. You’ll also get free preventive care even if you haven’t met your deductible. From there, you’ll have a very high deductible on your plan: $8,700 for an individual and $17,400 for a family in 2022. Your health insurance provider pays 100% of your care costs once you meet that deductible. You can only see in-network doctors with a catastrophic plan.
Please note that not all health insurance providers offer all types of plans. Some providers only offer 1 type of plan, while others offer all 4. Be sure to check with your plan provider and understand the plan structure before you lock yourself into health insurance.
what does health insurance cover?
The Affordable Care Act (ACA) instituted a series of controls on health insurance plans and providers. One of the biggest changes is that every health insurance plan, regardless of tier or provider, must offer at least some coverage for 10 “essential benefits.” Those benefits are:
- Outpatient care and services: This is outpatient care you get before you are admitted to the hospital.
- Emergency services: >Insurance Providers must provide coverage for emergency care from any provider, regardless of whether the hospital is in your network or not. Your insurance provider cannot require you to see any specific care provider in an emergency.
- Hospitalization: This includes planned and emergency surgeries, as well as overnight stays.
- Prescription Drugs: Your health insurance provider must offer coverage for prescription drugs. however, they may require you to try less expensive generic drugs before moving on to more expensive brand-name treatments. your doctor can request an appeal to skip this step if he or she thinks generic treatments will be dangerous or ineffective.
- Lab services: Lab services include blood tests and imaging tests .
- pregnancy, maternity and newborn care: includes care before and after delivery, as well as employment services.
- mental health and substance abuse treatment: All plans must cover behavioral health therapy, inpatient behavioral and mental health services, and substance abuse treatment. Your insurance provider may not impose annual or lifetime spending limits on the treatment of a certain condition or illness.
- Preventive and wellness services: This includes things like exams blood pressure checks, immunizations, boosters, and STD screenings.
- Rehabilitative and Habilitative Services and Devices: This includes physical and occupational therapy, as well as devices and aids for mobility.
- pediatrics care: Health insurance providers must provide dental and vision coverage to children, but are not required to provide these services to adults. you may be able to purchase dental and vision coverage as add-ons.
These are the minimum services that must be covered by all types of plans that comply with ACA. Please note that if you purchase a short-term health insurance plan, these requirements do not apply.
what does health insurance not cover?
Most health insurance plans do not cover the following treatments and therapies:
- Travel vaccinations: Your insurance provider must offer coverage for vaccinations that are medically necessary. boosters, flu shots, and immunizations are crucial parts of most health care providers’ medically necessary treatment lists. however, your plan may not cover vaccines that are only required for international travel.
- Weight-loss surgery: There is no federal mandate that requires providers to of private health insurance plans offer coverage for bariatric surgery. Do you think someone on your plan might need bariatric surgery in the future? Check with insurance representatives before signing up for a plan.
- Cosmetic Surgery: No insurance plan provides coverage for procedures that are not medically necessary. this includes injectables, fat reduction surgeries, and other types of cosmetic enhancements.
- dental, vision, and hearing coverage: ACA-compliant plans must only provide dental coverage and vision for children. Do you need dental, eye or hearing protection for adults on your plan? you may be able to purchase an additional package from your health insurance provider.
These are just a few examples of items that are not covered by most health insurance providers. Unless a particular treatment is listed as an essential benefit under ACA, there is no guarantee that your insurance provider will cover it. ask your representative for more information about what is and is not covered by your plan. In your search for affordable health coverage, you might also consider discount health plans or ask the provider if they accept cash. consider all your options before making a decision.
find affordable coverage for you
The question of how to get health insurance used to involve an endless comparison of policy inclusions and exclusions. ACA-compliant plans have made things a lot easier for you. however, please remember that these standards only apply to permanent health care plans. Remember to read the plan’s terms and conditions carefully if you’re considering a low-cost, short-term plan. When you want to know how to get affordable health insurance, remember that you get what you pay for in most cases.