- Who can get coverage through NY State of Health?
To shop in NY State of Health, you:
Must live in New York
Must be a US citizen, national, or lawfully present immigrant (Different immigration rules may apply if you are eligible for Child Health Plus or NYS Medicaid based on your income)
Cannot be currently incarcerated. (Different rules may apply if you are eligible for Medicaid based on your income.)
Cannot be applying for coverage of nursing home care or care provided in a Residential Treatment Facility for Children and Youth, Developmental Center or Intermediate Care Facility for the Developmentally Disabled.
- When can I enroll in health insurance through NY State of Health?
When you can enroll depends on which program you are eligible for, which is based on age, income and other factors.
Enrollment is open all year if you are eligible for:
You can enroll in a Qualified Health Plan during the annual Open Enrollment Period, or a Special Enrollment Period, if you are eligible. Learn more about enrollment periods.
American Indians and Alaskan Natives can enroll anytime during the year for any NY State of Health program.
- How can I apply?
There are three ways to apply for and enroll in health insurance through NY State of Health:
Apply online through the NY State of Health website
By phone at 1-855-355-5777 (TTY: 1-800-662-1220)
With the free help of a trained and certified enrollment assistor
- What do I need to apply for coverage through NY State of Health?
We ask about income and other information about you to tell you what coverage you qualify for and if you can get help paying for it. We keep all of the information you provide private, as required by law. When you enroll, have this information ready for all members of your family:
Social Security numbers (or document numbers for legal immigrants who need health insurance)
Birth dates
Employer and income information for everyone in your family
Policy numbers for any current health insurance
Information about any job-related health insurance available to your family
- Who should I include on my application?
Your income and family size help us decide what programs you qualify for. Include these people on your application for health insurance:
Yourself
Your spouse, if you are married
Any children you are caring for who live with you
Your partner, who lives with you
Anyone you include on your federal income tax return
You do not have to file taxes to apply for health insurance through NY State of Health. Anyone else who lives with you will need to file their own application if they want insurance. Not everyone has to be living at the same address to apply on the same application.
- When enrolling through the website, can I save my application and come back later?
Yes. The website lets you fill out part of the form and then saves your progress. You can come back later if you are not able to complete the form all at once.
- How long will it take me to apply?
Completing the online application will take about 45 minutes. Applying over the phone will take 45 minutes to 1 hour. If you are not requesting financial assistance, it will not take as long to complete the application.
- I am moving to New York in the next few months. Can I apply for health insurance in New York now?
You can apply for health insurance through NY State of Health if you are moving to New York State for a job or to find a job within the next 90 days. However, you cannot enroll in a health plan until you have moved to New York State and have told us your new address. You can update your address by logging into your Marketplace account or calling us at 1-855-355-5777.
- Where can I get help with applying and understanding my insurance options through NY State of Health?
NY State of Health certified enrollment assistors are able to guide you through the application and enrollment process. Their help is available at no cost. They can help you enroll in a health plan that is right for you based on your needs. They can also help you figure out if you can get help reducing the cost of your coverage. You can get help in person where you live or work, and by phone. You pick what works best for you. Click here to find an enrollment assistor who can help you.
You can also get help by phone from the NY State of Health Customer Service Center or online through the website’s “Chat with Us” feature.
- Can I qualify for financial assistance or public health insurance programs through NY State of Health if I have other health insurance?
You can still apply for health insurance through NY State of Health if your employer offers health insurance. If the insurance offered by your employer does not meet minimum value or is unaffordable, then you may be eligible to enroll in coverage with financial assistance or public health insurance programs through NY State of Health.
Some consumers who have employer coverage which does meet minimum value standards and/or is affordable may also be able to become eligible for Medicaid as secondary coverage. To learn more, call the NY State of Health Customer Service Center or speak with an enrollment assistor.
- Can I still apply for health coverage through NY State of Health if I have other insurance?
You and your family may still be eligible for Medicaid even if you have other health insurance that meets minimum essential coverage (MEC) standards and affordability rules. Based on the information you tell us about your other insurance, NY State of Health will even see if Medicaid can help pay for your other health insurance premiums under the Health Insurance Premium Payment program.
If you have other health coverage that does not meet MEC standards or that does not meet the affordability rules, then you may report this and may be able to become eligible for any program in NY State of Health, if otherwise eligible.
- Can I enroll in health insurance through NY State of Health if I already have a serious health problem?
Yes. Under federal law, pre-existing conditions do not impact consumers’ eligibility for coverage. This means that you cannot be charged more because of your health problem.
- Can I still get health insurance if I am disabled or chronically ill?
You may still qualify for health insurance if you are disabled or chronically ill. Chronically ill persons include persons who cannot work for at least 12 months because of an illness or injury. They also include persons who have an illness or disability that has lasted or is expected to last for at least 12 months. The Marketplace will make sure that you get the right services. This may involve referring your application to your Local Department of Social Services for additional assistance.
- What if I speak or read in a language other than English?
New York is a diverse state with many people that may speak or read in a language other than English. Call NY State of Health at 1-855-355-5777 for more information or help applying for coverage in your preferred language. All help is free.
Enrollment assistors also speak a variety of languages and have access to interpreter and translation services. Click here to search for an enrollment assistor who speaks your preferred language.
- Why do I need to provide a Social Security number (SSN)?
NY State of Health needs Social Security numbers for everyone who has one and is applying for health insurance. We use SSNs to check federal and state data sources to help speed up the application process. Providing your SSN can be helpful even if you do not want health coverage.
Some consumers who are not eligible for a Social Security Number may still become eligible for health insurance coverage through NY State of Health.
- Can I give someone else permission to get information about my application?
Anyone can call us to ask general questions, but we cannot discuss specific information about your application with anyone else, unless you give us permission to do so. You can give a trusted friend, relative, partner, or lawyer permission to talk with us about your application, and to act for you on matters related to your application. This person is called an authorized representative. You can call 1-855-355-5777 to find out how to name someone as your authorized representative.
- Why does the NY State of Health application ask about race and ethnicity?
As part of the application process, there are optional questions about each applicant's race and ethnicity. You do not have to answer these questions, but answering them can help us serve your community better. Giving us this information will not affect your eligibility, plan choices, or access to programs.
- What benefits do American Indians or Alaska Natives get through NY State of Health?
American Indians and Alaska Natives recognized by the U.S. government may qualify for special health care cost-sharing and other benefits as a result of the Affordable Care Act. These include:
Enrolling in a health plan at any time of the year
No cost sharing such as deductibles or copayments if the household income is below 300% of the federal poverty level and the individual is enrolled in a qualified health plan in the Marketplace
The ability to change a health plan once per month, if they are enrolled in a qualified health plan
For more information, click here.
- What if I need coverage for nursing home care?
You cannot currently apply for coverage of nursing home care through NY State of Health. You need to apply for Medicaid coverage of nursing home care through your Local Department of Social Services. If you need help finding contact information for your Local Department of Social Services, please call the NY State Medicaid Help Line at 1-800-541-2831 or visit health.ny.gov/Medicaid.
Please Note: If you already have coverage through Medicaid or the Essential Plan through NY State of Health, you may qualify for coverage of nursing home care for a limited time through your health plan. Please contact your health plan for more information.
- What if I need coverage in a Residential Treatment Facility for Children and Youth, Developmental Center or Intermediate Care Facility for the Developmentally Disabled?
A Medicaid application can be completed after you are admitted to a Residential Treatment Facility for Children and Youth, Developmental Center or Intermediate Care Facility for the Developmentally Disabled. For application assistance, please contact the director of the facility in which you are placed.
- What is the Address Confidentiality Program?
The Address Confidentiality Program is administered by the Department of State for victims of domestic violence. To learn more about this program, visit http://www.dos.ny.gov/acp.
- Why does NY State of Health need to know how much money I make?
Eligibility for financial assistance to help pay for health insurance is based on a variety of factors, including how much money you expect to make in the upcoming year. This includes income from a job as well as other types of income, such as unemployment benefits and Social Security.
- Can my child still enroll in Child Health Plus if I have health insurance through the New York State Health Insurance Program (NYSHIP)?
No, if your child has access to State Health Insurance Benefits through NYSHIP, he/she will not be able to enroll in Child Health Plus.
State Health Benefits Plans provide health insurance through the New York State Health Insurance Program (NYSHIP). Coverage is offered to employees/retirees of New York State government, the State Legislature and the Unified Court System. Some local government agencies and school districts also elect to participate in NYSHIP. If you are not sure, check with your employer.
- Am I eligible for health insurance if I am incarcerated?
If you are incarcerated (except for pending disposition), you are not eligible to purchase health insurance through NY State of Health.
You may, however, be eligible for Medicaid during this time, if otherwise eligible. During incarceration, Medicaid coverage is limited to inpatient hospitalizations provided off the grounds of the correctional facility. The correctional facility is responsible for all other medical care and treatment provided to you.
- What if I cannot afford to buy health insurance, or I don't want to buy health insurance for another reason?
Starting in 2019, there is no Individual Mandate penalty in effect. This change was made at the federal level as part of the Tax Cuts and Jobs Act enacted in December 2017. But, there are many financial and health reasons for enrolling in a health plan.
If the health coverage available to you through a job or the NY State of Health is unaffordable, and you still wish to enroll in coverage, you can apply for an affordability exemption to enroll in catastrophic coverage.