Now that you’ve enrolled in a health plan through NY State of Health, you may have some questions about how to use your health plan coverage. Here are some resources with answers to the questions you may have:
These summaries show the benefits or health services that are covered by 2014 "standard" health plans offered in NY State of Health. Standard plans must have 10 Essential Health Benefits required by NY State of Health.
Summaries also show the amount you may pay (deductibles, copays) for those services.
Your best protection against fraud is being informed! Starting October 1, 2013, you can apply for health insurance through NY State of Health, The Official Health Plan Marketplace, on nystateofhealth.ny.gov. This document describes ways you can protect yourself from fraud.
Introducing New York's Official Health Plan Marketplace, NY State of Health™. It's your place to shop, compare and enroll in a low-cost quality health plan that is right for you. And it is the only place you can receive financial assistance based on your income, to lower your costs even more.
Plans offered in NY State of Health are available in four easy-to-compare metal tiers (platinum, gold, silver and bronze). Plans on the Marketplace cover doctor’s visits; hospital stays; emergency care; maternity and newborn care; mental health and substance abuse disorder services; prescription drugs; rehabilitative and habilitative services and devices; laboratory services; preventive and wellness services, chronic disease management and pediatric dental and vision.
Marketplace Customer Service Center Representatives and In-Person Assistors/Navigators, who guide consumers through the process of shopping for and enrolling in health insurance, are available to help consumers in their language. Customer Service Center Representatives, who are available by phone, can accommodate more than 170 languages through staff and translation assistance. In-Person Assistors/Navigators speak the languages spoken in the communities they serve.
To inform the design and development of the Small Business Health Options Program (SHOP) Exchange, New York retained Wakely Consulting to interview a sampling of the state’s small employers regarding health insurance coverage issues. Employers interviewed included those who do and do not currently offer coverage to their employees.
KPMG conducted an analysis to assess the needs of employers, producers, insurers, employees and the Small Business Health Options (SHOP) Exchange to assist in planning for the design, implementation, and operation of a successful SHOP Exchange in New York State.
It is important to understand how health insurance works. Definitions of key health insurance and health care terms such as co-payment, deductible and coinsurance can be found in this glossary.
