Healthy New York is a state sponsored plan designed to provide health insurance to uninsured workers and their families. The program offers streamlined health insurance coverage to individuals and small employers by offering standardized health insurance benefit packages that are offered by all HMOs.
· Healthy New York offers benefits to small employers, sole proprietors, and uninsured working individuals. Eligibility for Healthy New York varies depending on the applicant.
· Small employers may be eligible if they employ 50 or fewer employees, at least 30% earn $38,000 a year or less, has not offered health insurance during the past 12 months, at least 50% of employee participate in the plan (at least one participant must earn $38,000 a year or less), and the business must be located in New York state. Additionally, the employer and the employee must equally share the cost of the premiums
· Individuals and sole proprietors may be eligible if they work for an employer that does not provide health insurance, they earn no more than 250% of the federal poverty level. For a family of 3, this works out to an annual income of $45,775 or a gross monthly income of $3,815. Additionally, the individual must have been uninsured for the last 12 months or have lost coverage due to a qualifying event, including loss of employment, death of a family member, change of residence, change of employer, divorce, or loss of eligibility of health coverage.
· Healthy New York offers two standard benefits packages, one with limited prescription drug coverage and one without. The benefit plan covers doctor’s visits, hospital care, maternity, adult preventative care, diabetic supplies and equipment, x-rays and lab services, and emergency care. Enrollees are required to obtain services from within the network and are responsible for co-payments.
· The cost of coverage varies depending on where you live and the type of coverage you elect. To find out more about costs, please visit the Healthy New York web site at: http://www.ins.state.ny.us/website2/hny/english/hny.htm.
· To request an application or for additional information, you may contact Healthy New York at (866) HEALTHY NY (866-432-5849).