On March 1, 2024, the federal government approved New York’s Essential Plan (EP) expansion waiver for populations with incomes 250 percent of FPL who would otherwise be ineligible for the Essential Plan. Over 1.5 million low-income consumers are enrolled in EP coverage. Under the amended waiver, New York will extend cost-sharing subsidies to Qualified Health Plan program enrollees starting in 2025.
More information about the cost-sharing initiatives for 2025 can be found here.
To learn if you can get help paying for your insurance and to see which plans you are eligible for, use the "Compare Plans and Estimate Cost" tool on the Individuals and Families page. If your family has an offer of health insurance from an employer, use the Employer Health Insurance Affordability Calculator to estimate if you or your family members may be eligible for financial assistance through NY State of Health.
In addition, we have several more tools available to you for comparing plans by County of residence, participating hospitals, facilities, or providers.
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To do our job, the Marketplace must make many decisions about how your situation fits the rules for different health care programs. Sometimes, you will not agree with the eligibility determinations we make. When this happens, you can ask us to reconsider and change our determination.
A request to change our determination can be made by contacting the Marketplace through the informal review process and by requesting an appeal.
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1095-A
If you or a family member enrolled in Qualified Health Plans (QHP) purchased through NY State of Health at the Bronze, Silver, Gold and Platinum levels for all or part of the year you will need Form 1095-A to complete your federal tax return.
Watch this video on how to access and use your 1095-A or you can view the 1095-A Support Topic.
1095-B
Form 1095-B is available by request for consumers who, were enrolled in Medicaid, Child Health Plus or EP during the past year. Please contact NY State of Health to request a Form 1095-B.
- Phone: 1-800-541-2831
- E-mail: 1095B@health.ny.gov
- Mail: NY State of Health P.O. Box 11774, Albany, NY 12211
Learn more about 1095-B.