NYS Health Insurance, You need to Know
The NYS Health insurance is a program dedicated to NYC residents. Through a feature called NY state health insurance Marketplace, the New Yorkers can buy online or by phone call insurance. The Marketplace is controlled by the government.
NYS Health Insurance Marketplace
The Marketplace (created as people for it) is created for those who:
- Have no insurance (individual or by their employer)
- Do not have Medicare
- Are not included into their spouse’s insurance
- Have problems with getting insurance before
- Already have private insurance but willing to have another insurance options
- Own a small-scale business
The people of New York are able to sign up (or change insurance coverage) in 60 days if they experience birth of child, lose their job, or move to another state; do not wait until the next period of enrollment, or the New Yorkers can sign up for Medicaid any time they want (only for those who are eligible).
The people of New York will need to provide information about their family members when they sign up. There some information they will need:
- Social Security number
- The legal immigrant document number
- Wage and tax statements for all employed family members.
Provide an estimate income for a self-employed or who does not have a regular salary.
- Health insurance policy numbers cover any members of the family
- Citizenship or immigration status
Plans of NYS Health Insurance
All Marketplace insurance plans are sold by private companies. There are four types / levels of coverage: bronze, silver, gold, and platinum. These plans have almost the same kinds of benefits; they are only distinguished from the amount of fees to be paid. There is also a so-called catastrophic plan. Catastrophic plans are commonly used by those under 30 years old.
Here is the coverage of each plan:
Those who follow this plan are requiring to pay 40% of the total cost and the insurer will pay off the rest.
- Silver Plan
They must pay 30% of the cost of treatment and care during the hospital and the remaining 70% will be paid by the insurer.
- Gold Plan
They will pay 20% and the insurer pays 80%.
- Platinum Plan
The plan will pay 90% of the total cost incurred and the participants of this plan will only pay 10%.
With this plan, insurance will only cover the cost of treatment at a partner physician, unless an emergency condition occurs. This means that you will bear all your medical expenses if you use the services of a physician other than a partner physician. The Insurer may cover medical expenses by a specialist, only if the specialist is a doctor recommended by a partner physician.
- PPO and POS
Both plans allow you to visit doctors and non-partner hospitals by paying a small amount of extra charges.
The difference between PPO and POS lies in the referral to a specialist. PPO participants do not need a recommendation whilst a specialist doctor’s visit for POS participants requires recommendations from a doctor / partner hospital. The amount of dues to be incurred by NYS Health insurance participants is subject to the type / level of insurance, the number of family members, and the age.