Health Insurance in New York

Find plans and explore healthcare options in the Empire State.

Understanding New York's Healthcare System

New York operates a comprehensive healthcare system featuring its own state-based health insurance marketplace, **NY State of Health** (nystateofhealth.ny.gov). This platform serves as a one-stop shop for New Yorkers to explore various coverage options, including private health plans with federal financial assistance, Medicaid, Child Health Plus (CHIP), and the state's unique **Essential Plan**. New York expanded Medicaid eligibility under the Affordable Care Act (ACA) and utilized ACA provisions to create the Essential Plan, offering very low-cost or free coverage to lower-income residents who don't qualify for Medicaid. Notably, New York State **prohibits the sale of traditional short-term health insurance plans**.

Navigating health insurance in New York primarily involves using the NY State of Health website or its customer service center. This single application point determines eligibility for all programs – from subsidized private plans (Qualified Health Plans) to the Essential Plan, Medicaid, and Child Health Plus. Understanding this integrated system is key for residents to find the most affordable and appropriate coverage.

With year-round enrollment available for public programs and an extended Open Enrollment for private plans, New York aims for continuous access to coverage. Use our free tools to get an instant quote for private plans or evaluate local market rates available through NY State of Health.

Map of New York highlighting healthcare

New York Health Insurance Coverage ()

Employer

~51%

Non-Group/Other

~7%

Medicaid/CHIP

~28%

Medicare

~15%

Military

~0.5%

Uninsured

~4.8%

Source: Approximate percentages based on KFF analysis of 2023 ACS data. Note: Categories may overlap; percentages may not sum exactly to 100%. Public coverage rates are high due to Medicaid, CHIP, and the Essential Plan.

New York Health Facts at a Glance

Overall Health Ranking

#23

Est. Population (2025)

~19.5 M

Avg. Lifespan

~79.0 yrs

Avg. Hospital Stay / Day

~$3,500+

Avg. Health Expenditure / Person

$14,007*

Number of Hospitals

~210+

*Avg. Health Expenditure per capita (KFF, 2020 data). Other stats based on most recent available data (2021-2024) - All stats are illustrative and need updating.

Health Insurance Programs for New York Residents

New York provides health coverage through a variety of comprehensive state and federal programs, accessible via a single application portal:

  • NY State of Health (nystateofhealth.ny.gov): New York's official health insurance marketplace. This is the single point of entry to apply for all individual and family coverage options, including private plans (Qualified Health Plans), the Essential Plan, Medicaid, and Child Health Plus. It's the only place to receive federal premium tax credits for private plans.
  • Medicaid: Provides comprehensive, free health coverage for eligible low-income New Yorkers, including adults covered under the ACA expansion, pregnant individuals, children, seniors, and people with disabilities. Apply year-round through NY State of Health.
  • Child Health Plus: New York's Children's Health Insurance Program (CHIP) offering free or low-cost coverage for nearly all children under 19, regardless of family income (premiums apply at higher incomes) or immigration status. Apply year-round through NY State of Health.
  • Essential Plan: A unique New York program providing comprehensive health coverage with very low or $0 monthly premiums and low cost-sharing for lower-income adults who don't qualify for Medicaid or Child Health Plus (typically up to 250% FPL). Apply year-round through NY State of Health.
  • Medicare: The federal insurance program for people aged 65 and older, and younger individuals with certain disabilities.
  • Patient Assistance Programs: Various manufacturer programs may help lower the cost of specific prescription drugs.

The integrated application process through NY State of Health simplifies finding the right program based on eligibility.

New York Short-Term Health Insurance

Important Note: The sale of new Short-Term Health Insurance plans is BANNED in New York.

New York State law prohibits the sale and issuance of short-term, limited-duration health insurance plans because they do not meet the state's minimum standards for comprehensive coverage and guaranteed renewability. These plans often lack essential benefits and consumer protections.

Residents of New York needing health coverage must enroll in ACA-compliant plans through NY State of Health (private plans, Essential Plan), Medicaid, Child Health Plus, employer-sponsored plans, or Medicare. Standard short-term health insurance is not a legal coverage option in the state.

Finding Health Coverage In New York

Finding health insurance in New York is streamlined through the state's official marketplace, NY State of Health. This platform serves as the gateway to determine eligibility and enroll in all available individual and family coverage options, from private plans to public programs.

New York Enrollment Periods via NY State of Health

Enrollment for health coverage in New York is facilitated through **NY State of Health (nystateofhealth.ny.gov)**. While the official Open Enrollment Period for private Qualified Health Plans (QHPs) typically runs from **November 1st through January 31st**, New York offers broader enrollment opportunities. Enrollment in the **Essential Plan, Medicaid, and Child Health Plus is available year-round** for eligible individuals. Even for private plans, Special Enrollment Periods may be available outside Open Enrollment due to qualifying life events. Check the NY State of Health website for the most current enrollment information.

New York Health Insurance Quotes & Costs

Affordable Care Act (ACA) compliant private plans (QHPs) can be compared and purchased through **NY State of Health (nystateofhealth.ny.gov)**. This is the only place to access federal premium tax credits to lower the cost of these plans. Additionally, NY State of Health determines eligibility for the **Essential Plan** (very low/no premium coverage for eligible lower-income adults) and **Medicaid/Child Health Plus** (free or low-cost coverage). Because of these robust public options, many New Yorkers qualify for comprehensive coverage with minimal or no monthly cost. Comparing options via the single NY State of Health application is essential. Our free quoting service can help estimate costs for private plans, but applying through NY State of Health is necessary to determine final costs and eligibility for all programs.

Major Health Insurance Providers in New York

New York has a diverse and regionally segmented health insurance market. Numerous carriers offer plans through NY State of Health, providing choices across different parts of the state. Major participants often include:

  • Fidelis Care
  • MetroPlus Health Plan (NYC area)
  • UnitedHealthcare
  • Excellus BlueCross BlueShield (Upstate NY)
  • Highmark BlueShield of Northeastern New York
  • Highmark BlueCross BlueShield of Western New York
  • MVP Health Care
  • Independent Health (Western NY)
  • EmblemHealth / HIP (NYC area)
  • Oscar Insurance Corporation

It is critical to use the NY State of Health website to see which specific insurers and plans are available in your county, as offerings vary significantly by region.

Compare plans based on network providers (doctors, hospitals), covered benefits, drug formularies, and total estimated costs (premium after aid + out-of-pocket expenses). Free assistance from NY State of Health Navigators and certified brokers is available.

Frequently Asked Questions About Health Insurance New York

Is Health Insurance Mandatory in New York?

No, **New York does not have a state-level individual mandate** requiring residents to have health insurance or pay a penalty. The federal penalty for not having coverage is also $0. While coverage is not mandated by penalty, it is strongly encouraged for health and financial security. New York focuses on making coverage accessible and affordable through its various programs.

What's the Cost of Health Insurance in New York?

The cost varies greatly depending on income, location, plan choice, and family size. However, New York offers extensive financial help. Through **NY State of Health (nystateofhealth.ny.gov)**, eligible residents can get federal premium tax credits for private plans. More significantly, many New Yorkers qualify for the **Essential Plan** (very low or $0 premium, low cost-sharing) or **Medicaid/Child Health Plus** (free or very low cost). Because of these programs, comprehensive coverage is often highly affordable or free for a large portion of the state's population. Using the application on NY State of Health is the definitive way to determine your actual cost. Our free estimate tool can provide baseline rates for private plans before aid.

How to Secure Health Insurance in New York?

The primary ways to get health insurance in New York are:

  • Employer-Sponsored Plans: Coverage offered through a job.
  • NY State of Health (nystateofhealth.ny.gov): The single portal to apply for and enroll in Qualified Health Plans (with federal subsidies), the Essential Plan, Medicaid, and Child Health Plus. Enrollment for public programs is year-round; private plan enrollment is typically Nov 1 - Jan 31 or via SEP.
  • Medicare: Federal program for those 65+ or with certain disabilities.
  • Directly from Insurance Companies: Less common for individual coverage; no financial help available this way.
  • Short-Term Plans are BANNED: Not a legal option in New York.
Free enrollment assistance is widely available through NY State of Health Navigators and certified brokers/agents.

The Impact of Obamacare on New York Insurance Rates

The ACA (Obamacare) enabled New York to significantly enhance its healthcare system. The state established its own marketplace, **NY State of Health**, expanded **Medicaid** coverage, and leveraged the ACA's Basic Health Program option to create the highly successful **Essential Plan**. These actions dramatically reduced the uninsured rate and made comprehensive coverage accessible to millions more New Yorkers, often at very low or no cost. While underlying healthcare costs remain high, the ACA framework, actively implemented and enhanced by New York, has vastly improved affordability and access compared to the pre-ACA landscape. New York banned short-term plans to further strengthen the comprehensive insurance market.

Bottom Line

Navigating health insurance in New York is best done through the state's official portal, **NY State of Health (nystateofhealth.ny.gov)**. This single application point determines eligibility for all options: private plans with federal subsidies, the unique low-cost Essential Plan, Medicaid, and Child Health Plus. Enrollment in public programs is year-round. Compare plans from regional carriers carefully, noting network differences. Remember, short-term plans are banned, and there's no state mandate penalty. Use our quote tool or estimate tool to explore private plan costs, but apply via NY State of Health to access all potential financial help and program options available to you in New York.