New York Health Insurance

New York imposes relatively strong regulatory limits on its local health insurance industry, so finding good coverage here probably won’t be quite as challenging as in some other states.  That doesn’t mean you shouldn’t know about the pitfalls that do exist here, of course, and being better-informed can only help in your efforts to get the best coverage possible for your insurance dollar.  To help you get your bearings, we offer the following summary of noteworthy health insurance regulations in New York.

• Insurers in this state are required by law to include a guarantee of renewability in every health insurance policy they sell.  This means that, as long as you’ve kept up with your premium payments, you cannot be prevented from renewing your coverage as many times as you choose.  You are also assured under state law that your coverage cannot be terminated on the grounds that your health has gotten worse.
• Newborns and newly-adopted children in New York are automatically covered under the parent’s health insurance, assuming that the policy in question can be applied to dependents.  This coverage lasts for up to 30 days, providing an opportunity to set up something more permanent.  Disabled dependents that are covered by a parent or guardian’s health insurance are also permitted to  retain this coverage, even after exceeding the policy’s stated maximum dependent age.
• New York health insurance regulations define a “pre-existing condition” as one that has been diagnosed or treated within six months before you start a given policy.  Insurers here are allowed to designate pre-existing conditions as exempt from coverage, but only for a maximum of twelve months after this coverage begins.  Switching to different health insurance can never result in you having to restart this waiting period, so long as you’ve kept up continuous coverage.
• By law, residents of New York are guaranteed the ability to buy health coverage regardless of age, health, gender, or similar considerations, and no insurer can legally deny or charge more for coverage on these grounds alone.  This goes for both individual and family health plans.
• Small businesses in New York are automatically qualified to purchase group health insurance, and every business with a staff of two to fifty people can expect to have access to coverage comparable to what is being offered to other small companies in the state.  Keeping this coverage may be contingent on meeting certain requirements, however, such as having at least a certain percentage of your employees enrolled in the plan at any given time.   The particular obligations involved can vary, but in no event can an HMO impose any such ultimatum.
• Much like individual coverage, small businesses’ group health plans cannot be cancelled due to poor health among those insured.  The cost of these plans may never vary on the basis of age, health, occupation or gender— other risk factors are fair game, however.
• Self-employed New Yorkers may be eligible to buy group coverage as any small business would, despite not having at least two employees on the payroll.  Availability of this kind of policy may depend on certain other factors, so you should check with state authorities if this option interests you.  Individual health coverage is available for self-employed workers just as it is to anyone else, and a portion of the premiums for this kind of health plan may be tax-deductible.

Many of the advantages available to New York residents in the health insurance market come on the condition that you maintain continuous coverage, so it’s a good idea to buy health insurance as early as possible to be ready for any future needs.  As long as you are willing to investigate your options and scrutinize any offers you receive, you stand a much better chance of finding high-quality, low-cost health coverage.

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