With the open enrollment deadline for the N.Y. State of Health fast approaching, many people have questions about finding the right coverage.
N.Y. State of Health was created as part of the federal Affordable Care Act to help all Americans obtain and afford health insurance coverage. Metal-level products are: platinum, gold, silver, bronze, catastrophic and child-only. Each metal level offers the same coverage but with different premiums, deductibles, and levels of cost-sharing. Open enrollment for metal-level products runs until Jan. 31 for coverage in 2016.
You also might be eligible for the new Essential Plan, a product for lower-income New Yorkers who don’t qualify for Medicaid or Child Health Plus. Available all year long, the plan offers comprehensive benefits with a monthly premium of $0 or $20, depending on income. Enrollment in Child Health Plus and Medicaid also takes place through the Marketplace throughout the year.
Fidelis Care’s Chief Marketing Officer Pam Hassen offers the following tips to local residents shopping for health insurance during this open enrollment period:
1. Find out the cost of coverage.
The cost of coverage is on the top of many people’s minds, but it’s not always as easy as looking at the premium rate that’s listed. Many individuals and families qualify for subsidies or tax credits that can lower their premiums and cost sharing. As a resource, Fidelis Care’s Affordable Care Advisor tool on fideliscare.org only needs basic information to calculate an estimated monthly cost. It can also determine if you may qualify for Medicaid, Medicare Advantage, or the Essential Plan.
2. Look at the benefits and copays.
Your premiums, copays and deductibles will differ depending on the metal-level product you choose. Higher premiums will likely mean lower copays and deductibles. Determine which plan best suits your needs.
3. Check to see if your doctor participates.
If you have a primary care doctor or specialist, or prefer to be treated at a certain hospital, find out if they are part of the health plan’s network for N.Y. State of Health products.
4. Learn which medications are offered.
If you take certain medications, check with the health insurer to see if they offer the medication as part of their formulary.
5. Meet with a trained representative.
You can enroll in N.Y. State of Health coverage online at www.nystateofhealth.ny.gov, but if you have questions, meeting with a representative for assistance can help. They have the training and expertise to answer your questions and guide you through the application process.
Connecting with Fidelis Care
For more information about the N.Y. State of Health, call Fidelis Care at 1-888-FIDELIS (1-888-343-3547), visit fideliscare.org, or meet a representative at a Fidelis Care Community Office location:
• Bronx Community Office: 815 East Tremont Ave., Bronx, NY 10460; Phone: 718-896-2531
• Chinatown Community Office: 185 Canal St., Suite 406, NY, NY 10013; 212-226-6157
• Flushing Community Office: 36-36 Main St., Suite 2SB, Flushing, NY 11354; Phone: 718-896-4511
• Jamaica Community Office: 146-01 Jamaica Avenue Jamaica, NY 11435; 718-906-0800
• Inwood Community Office: 100-02 Post Ave., New York, NY 10034; Phone: 212-942-3111
• Patchogue Community Office: 232 East Main St., Suite D, Patchogue, NY 11772; Phone: 631-475-7200
• Ridgewood Community Office: 1674 Putnam Ave., Ridgewood, NY 11385; Phone: 718-896-2694
• Spring Valley Community Office: 175-11 Route 59, Spring Valley, NY 10977; Phone: 845-356-0194
• Staten Island Community Office: 1686 Forest Ave., Unit D, SI, NY 10302; Phone: 718-420-1236
• Sunset Park Community Office: 837 58th St., 4th Floor, Brooklyn, NY 11220; Phone: 718-633-5308
• Westbury Community Office: 180 Post Ave., Westbury, NY 11590; Phone: 516-334-6588
• Yonkers Community Office: 419B South Broadway, Yonkers, NY 10705; Phone: 914-233-5222
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