Jump right to it: To get the best health insurance in New York, get quotes from competing companies using this form.
The best health insurance company in New York is generally Fidelis Healthcare, but getting competing quotes could save you money. The Fidelis Healthcare company is also the best plan if you qualify for Medicaid.
The costs of health care continue to climb, so health insurance is essential. You might not think that you can afford health care if you live on a limited budget. However, thanks to the institution of the Affordable Care Act, low-cost health insurance plans are easier to find than ever before. Here's a quick look at the best health insurance companies in New York.
Best Health Insurance in New York (NY)
- Best for Those Who Qualify for Both Medicare and Medicaid: Fidelis Healthcare
- Best for Low or $0 Premiums: Univera Healthcare
- Best Catastrophic Insurance Plan: Empire Blue Cross
- Same-Day Coverage Available: United Healthcare
Now that you understand how health insurance works, let’s take a look at some of the best health insurance plans in New York that offer affordable rates. Do your research and click through to check out each provider so that you can find the cheapest health insurance in NY that offers the most value.
1. Best for Those Who Qualify for Both Medicare and Medicaid: Fidelis Care
Fidelis Care may offer an affordable plan option if you need cheap health insurance coverage in NY and you qualify for both Medicare and Medicaid.
Fidelis Care’s Dual Advantage plan helps policyholders seamlessly bridge the gaps between Medicare and Medicaid with almost no out-of-pocket costs. This is why it’s an excellent choice for anyone with a disability or who lives on a fixed income.
Fidelis Care also offers some of the most affordable private plan options in New York, which makes it a top choice for affordable health insurance in New York.
- Because it works for those on Medicaid or Medicare, it is much easier to maintain over a long period of time
- Those with disabilities can more easily get the services and care they need
- The coverage is more affordable because it was designed for those on a fixed income
- Fidelis may not prove to helpful if you do not qualify for Medicare or Medicaid
2. Best for Low or $0 Premiums: Univera Healthcare
Another viable option for low-cost health insurance plans is Univera Healthcare, which offers individual, family and Medicare/Medicare Advantage plans. In fact, Univera is the best affordable health plan in New York for individuals and families.
Univera Healthcare’s Essentials plan includes premiums as low as $0 per month and additional discounts on deductibles for low-income families.
Univera Healthcare offers plans throughout New York state — so no matter where you are, you’ll likely be able to find an office close to you. Plus, all of Univera’s plans offer free preventive care, including shots, checkups and screenings.
- Serves those in New York State very well because it has so many providers in the area
- Medicare plans are available, helping families maintain coverage over long periods of time, if they so choose
- Plans include some free services that can help families save money on the basics
- Not all premiums will be extremely low
3. Best Catastrophic Insurance Plan: Empire BlueCross
You can often save money by choosing a catastrophic plan if you’re young and relatively healthy. Empire Blue Cross Blue Shield offers comprehensive catastrophic plans, and its website easily allows you to see if you can qualify and get a quote.
Empire BlueCross is a fantastic resource if you want to save money and manage your health care on your own. Empire can offer a wealth of information on everything from preventive treatments to care scheduling.
Plans are even available for as little as $49 per visit for the most basic health coverage options.
- The catastrophic insurance plan is often a good choice for families that are afraid of overpaying for coverage
- You can check your account online and review claims so that you’re always up-to-date on your coverage
- The information that you find on the website can often help with your management of health conditions
- There is no guarantee that all pricing will be low or that all the information on the website will be easy to understand
4. United Healthcare
United Healthcare might be the health care provider for you if you value expansive networks.
United’s affordable plans include an impressive selection of care providers — it’s one of the largest health insurance providers in the nation.
United Healthcare also offers a number of plan choices which range from short term gap coverage to Medicaid options.
United Healthcare blends affordability with a large network and is one of the top providers for every style of health plan and beyond.
- The network of providers is very large, so much so that it’s easy to find someone who takes United
- Medicaid options are helpful for families with low incomes
- There are short-term policies available for those in between coverages
- Because United is so large, prices can vary widely
Average Cost of Health Insurance in NY
The average individual on private New York health insurance pays around $484 each month for coverage. However, the specific amount you’ll pay depends on a number of factors, including your location, plan type, the people on your plan, deductible, and the tax credit available to you. In finding these numbers, we reviewed the companies above along with other companies like AETNA and Humana insurance company.
Types of Health Coverage
There are multiple types of health insurance plans. Understanding the difference between each plan type can help you select the best provider depending on your needs. Let’s take a look at 4 of the most common types of health insurance plans.
- Health maintenance organization (HMO) plans: These plans require that you stay within the health insurance company’s network of service providers. Health maintenance org plans give you the least amount of freedom to choose the health care professionals you work with but also involve the least amount of paperwork. These plans are also usually some of the cheapest plans.
- Preferred provider organization (PPO) plan: Like a health maintenance organization, PPO plans include a network of preferred providers who are within the organization’s network. You may see doctors and specialists outside of your plan’s network — but you’ll pay an additional fee for service. PPO plans require a bit more paperwork if you visit a provider outside of your network, but you can earn discounts if you visit health care providers in your network. PPO plans are more expensive than a health maintenance org.
- Point-of-service (POS) plan: A POS plan is similar to a blend between the health maintenance organization and the preferred provider organization. POS plans allow you to see any primary care doctor you want to. Similar to a PPO plan, you’ll save money if you choose an in-network care provider, but you can pay extra to see an out-of-network doctor. Unlike a PPO plan, you’ll need to get a referral to see a specialist from your primary care provider. POS plans give you a bit more freedom to choose providers and also keep costs lower than a PPO.
- Catastrophic plan: You may be able to get a catastrophic plan If you’re under the age of 30. Catastrophic plans have high deductibles, but you’ll get 3 primary care visits before the deductible applies. You’ll also get free preventive care even if you haven’t met your deductible. From there, you’ll have a very high deductible on your plan — $9,450 for an individual and $18,900 for a family for 2024. Your health insurance provider pays for 100% of your care costs once you meet that deductible. You may only see in-network doctors with a catastrophic plan.
Keep in mind that not every health insurance provider offers every type of plan. Some providers only offer 1 plan type, while others offer all 4.
If you buy into an essential plan and experience a qualifying life event like marriage, divorce, childbirth, adoption, death in the family, etc., you will have the opportunity to adjust your health insurance options. You must notify the insurance company in writing (often using a form found on the carrier’s website), enter the appropriate enrollee information and choose a new plan from the NY State of Health marketplace.
Make sure you consult with your plan provider and understand the plan’s structure before you lock yourself into health insurance.
What Does Health Insurance Cover?
The Affordable Care Act (ACA) instituted a number of controls on health insurance plans and providers. One of the biggest changes is that every plan, regardless of tier or provider, must offer at least some coverage for 10 “essential benefits.” Those health benefits are:
- Ambulatory care and services: This is outpatient care that you receive before being admitted to the hospital.
- Emergency services: Insurance providers must provide coverage for emergency care from any provider, regardless of whether the hospital is in your network or not. Your insurance provider cannot require you to see any specific care provider in the event of an emergency.
- Hospitalization: This includes both planned and emergency surgeries as well as overnight stays.
- Prescription drugs: Your health insurance provider must offer coverage for prescription drugs. However, they may require you try less expensive generic drugs before moving onto more expensive brand name treatments. Your doctor may request an appeal to skip this step if he or she believes that generic treatments will be dangerous or ineffective.
- Laboratory services: Laboratory services include things like blood work and imaging tests.
- Pregnancy, maternity and newborn care: This includes care before and after birth as well as labor services.
- Mental health and substance abuse treatments: All health plans must cover behavioral health therapy, mental and behavioral health inpatient services and substance abuse treatments. Your insurance provider cannot place annual or lifetime spending limits on the treatment of a certain condition or disease.
- Preventive and wellness services: This includes things like blood pressure screenings, vaccinations, boosters and STD screenings.
- Rehabilitative and habilitative services and devices: This includes physical and occupational therapy as well as mobility devices and aids.
- Pediatric care: Health insurance providers must provide dental and vision coverage for children but are not required to provide these services for adults. You may be able to purchase vision and dental coverages as add-ons.
These are the bare minimum services that every type of ACA-compliant plan must cover. Other services like Medicaid Managed Care might be included, depending on the plan and the premium.
Keep in mind that if you purchase a short term health plan, these requirements don’t apply. If you’re not sure what might be covered, check your policy documents.
What Does Health Insurance Not Cover?
Most health insurance plans don’t cover the following medical treatments and therapies:
- Travel vaccinations: Your insurance provider must offer coverage for vaccines that are medically necessary. Boosters, flu shots and immunizations are crucial parts of most health care providers’ lists of medically necessary treatments. However, vaccines that are only required for international travel may not be covered under your plan.
- Weight loss surgery: There is no federal mandate that requires private health insurance providers to offer coverage for bariatric surgery. Do you think someone on your plan might need bariatric surgery in the future? Consult with insurance representatives before you enroll in a plan.
- Cosmetic surgery: No insurance plan provides coverage for procedures that aren’t medically necessary. This includes injectables, fat reduction surgeries and other types of cosmetic enhancements.
- Dental, vision and hearing coverage: ACA-compliant plans must only provide dental and vision coverage for children. Need dental, vision or hearing protections for adults on your plan? You may be able to purchase an add-on package with your health insurance provider.
- Substance use treatment: Treatment for substance abuse is often not covered by your health insurance, but you should view plans that are available and see what sort of coverage might be offered.
These are just a few examples of items that aren’t covered by most health insurance providers. Unless a particular treatment is included as an essential benefit under the ACA, there is no guarantee that your insurance provider will cover it.
Shop plans and consult your representative for more information about what is and isn’t covered under your medical plan. In your search for cheap health coverage, you may also want to look at health discount plans or ask the provider if they accept cash. Consider all your options before making a decision.
Factors to Consider When Choosing Health Insurance
As you select a health plan, there’s more to think about than the health insurance rates. You should consider:
- Providers on the plan: Are your providers a part of the plan? If not, it can be difficult for you to find another place to go for medical care.
- Medications covered by the plan: You need to know that the medications you take are covered and how much they cost. Many people get tripped up by insurance that doesn’t cover medications they need to take every day.
- Free services: Most health insurance plans offer some sort of free support or a range of free services. Make sure you know what you’re getting for free before making your purchase.
- Coinsurance: Coinsurance refers to percentage you pay.
Finding Affordable Coverage For You
The question of how to get health insurance used to involve endlessly comparing policy inclusions and exclusions. ACA-compliant plans have greatly simplified things for you. However, remember that these standards only apply to permanent health care plans. Group plans could vary.
Remember to carefully read the plan’s terms and conditions if you’re considering a low-cost short term health plan. When New Yorkers want to know how to get cheap medical insurance, they can research with Benzinga at any time. Some of the companies listed above also offer other products, like life insurance.
Frequently Asked Questions
Can I buy my own health insurance in NY?
You can buy your own health plan in NY using the state health insurance marketplace or visiting a licensed carrier’s website.
Can you get Obamacare in NY?
Yes, you can get Obamacare in New York through the state marketplace.
Who is eligible for NY State Health Insurance?
NY State of Health is designed for those under 65 who do not qualify for Medicaid or do not have employer-sponsored health insurance.
About Sarah Horvath
Sarah is an expert in the insurance, investing for retirement and cryptocurrency space.