What You Need to Know About Health Insurance in New York
3 min readHealth insurance is a legal contract that covers your healthcare costs in exchange for a monthly premium payment. Out-of-pocket expenses like deductibles and co-insurance typically must be covered upfront; however, premium tax credits may help offset this cost for eligible users.
Health insurance coverage is tightly regulated at both the state and federal levels, so the Affordable Care Act marketplace offers snapshots to make comparing plans easier.
What is health insurance?
Health insurance is a non-life insurance that compensates individuals for financial losses caused by illness or accidents. It works by collecting an up front premium that is then used to pay out medical costs when someone gets sick or injured; most healthy enrollees make payments which offset costs associated with those few enrollees who need intensive medical attention.
U.S. health insurance comes in many forms, from public coverage (Medicare and Medicaid administered by the federal government) to private plans obtained either through employers or purchased individually (small-group and individual/family policies regulated both state-wide and nationally).
Some plans offer coverage limits, meaning they will only pay up to a set limit on any particular service, leaving any excess charges up to the policy-holder to cover. Meanwhile, others include cost-sharing provisions like deductibles or copays intended to reduce out-of-pocket costs for insureds.
How do I get health insurance?
Health insurance provides better access to medical services while helping reduce high out-of-pocket expenses. In exchange for a monthly premium, health plans pay for you or your family’s healthcare costs; its cost will depend on which benefits are chosen and which type of plan purchased; plans available through New York Individual and Family Marketplace plans come from private insurance companies while additional plans may offer additional protections or features; your income level could make you eligible for subsidies that reduce monthly premium payments through this marketplace.
Coverage options vary based on your employer or as an individual; options include purchasing plans through the Affordable Care Act Marketplace, purchasing them directly through your state Medicaid program and opting-in during open enrollment or following certain life events (with 60 days allowed to make necessary changes); help is available both locally and online to manage this process and assist with changing plans as necessary.
What is the best health insurance policy for me?
As part of selecting an ideal health insurance policy, it is crucial that you consider both your budget and medical needs when making this choice. Be mindful of any monthly premium or deductible costs as well as out-of-pocket expenses you might need to incur; and ensure your preferred doctors or facilities are part of any plans being considered.
Know the coverage tiers of plans you are reviewing can help you to select one best suited to your medical needs and budget. For instance, someone expecting high medical expenses could benefit from choosing a platinum plan with lower monthly premiums and increased out-of-pocket maximums.
Check the claim settlement ratio (CSR). This measures how quickly and efficiently claims are settled by your health insurance provider. You can get this information online or ask your broker for more details.
How do I choose a health insurance plan?
No matter if you’re purchasing health insurance on your own or selecting plans from the marketplace, choosing an appropriate plan can be challenging. A great way to narrow down your choices is to take an overall cost approach when determining which policy best meets your needs – this means factoring both monthly premiums and usage-related charges such as deductibles, copays and coinsurance into consideration when making decisions.
Consider which doctors, pharmacies, and other providers you want to visit. Look for plans with those providers in their network so you can save money.
Take care to select an insurance plan with lifetime renewability; this ensures you will not need to change policies frequently.
When browsing individual health insurance on the marketplace, there are four price categories to choose from: bronze, silver, gold and platinum. Plans with higher monthly premiums usually offer reduced cost-sharing expenses such as deductibles and copays; you may even qualify for tax credits to help with both out-of-pocket expenses and your monthly premium costs.