10 Things New Yorkers Need to Know to Prepare for the New Health Benefit Exchange

In New York State, over 2 million of the 19 million residents lack health insurance.  Due to the Federal Affordable Care Act, most Americans will be required to have that insurance by January 1, 2014, or face tax penalties.

In preparation for these changes, below is a list of the top 10 things New Yorkers should be aware of in order to prepare for the health benefit Exchange:

1. There are three ways you will be able to get insurance:

  • Government – through programs like Medicare or Medicaid.  Lower income individuals and families will be covered this way.
  • Employer – Small employers with up to 50 employees will be able to access coverage for their employees in the Exchange.
  • Or purchase it – through the health benefit exchanges.  There will be government subsidies for families with incomes under $90,000 to purchase their insurance through these health marketplaces.  The lower the income, the larger the subsidy.

2. Starting in October 2013, you will be able to shop for and enroll in health insurance through the Exchange.

3. Coverage begins on January 1, 2014.

4. To apply on October 1, 2013 New Yorkers should visit, http://healthbenefitexchange.ny.gov/.

5. There will be assistance available in other languages:  Sometime in the first week of October, the New York Health Benefit Exchange website will be available in Spanish. A toll free customer service center will be open on October 1, 2013 to assist in nearly all languages.

6. If you have to purchase insurance directly, expect the cost of your premiums to go down.

7. The plans that will be available on the New York Health Benefit Exchange are “Qualified Health Plans”.   All health plans will be reviewed and approved by the exchange and all plans will be required to provide comprehensive coverage, follow limits on out-of-pocket expenses (such as deductibles, copayments, and out-of-pocket maximums), and meet other requirements.

8. It does not matter if you have a preexisting condition.  You will be able to purchase health insurance through the New York Health Benefit Exchange regardless of whether you have a pre-existing or chronic health condition. The amount you pay for insurance coverage will not be impacted by your health status.

9. There are New York community groups out there to help you. If you encounter any issues with applying for health insurance, contact Community Health Advocates at 888-614-5400 for assistance.

10. If you feel your rights have been violated, visit NY Legal Aid Help, to find a lawyer that can assist you.

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