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Low Cost Health Insurance Coverage for New York Residents

New York

Applications for Family Health Plus will not be accepted after December 31, 2013, because of changes under the Affordable Care Act. Starting January 1, 2014, individuals should apply for health insurance coverage through the Marketplace; https://nystateofhealth.ny.gov/

The Family Health Plus Insurance program is limited to adults between the ages of 19 and 64. Coverage is available to single individuals, childless married couples and parents who are New York residents. Adults covered by Family Health Plus Plan are not eligible for Medicaid, federal, state, county or municipal health plans.

The coverage provides a comprehensive health insurance plan with zero or low deductibles and no annual premiums. Family Health Plus insurance coverage includes dental services, hospice care, lab work, x-rays, prescriptions, physician services and more. The program is designed to help New York residents who earn too much to qualify for Medicaid but cannot afford the high costs of a medical health plan on their own.

Family Health Premium Assistance Plan

To cover situations for low-income individuals who are eligible to participate in an employer-sponsored health program, Family Health Premium Assistance Plan is available. The purpose of the Premium Assistance Plan is to help families/individuals pay the premiums, deductibles and coinsurance that can prove to be cost prohibitive for low-income New York residents.

Qualifying for Family Health Plus Plan

Qualification depends on both family size and income level. For example, effective January 1 of 2012 a single adult with an annual income of $11,170 (or monthly income of $931 or weekly income of $214) meets the income requirement for the plan.

The income level is incrementally adjusted to accommodate larger families which require more income. Couples without children, for example, may qualify if their combined income doesn’t exceed $15,130. The gross annual income/family size chart continues up to a family size of 7 individuals making an annual salary of $52,395. For each additional family member above and beyond the 7-member household, the annual salary cap is increased by $5,940. Therefore, a household with 8 members could earn as much as $58,335.

New York State revises the annual income qualification guidelines annually.

Low-Cost Health Coverage for Children

As mentioned earlier, children and not covered under the Family Health Plus program but New York has a separate health insurance program for children. The child may qualify for Medicaid or New York’s Child Health Plus program. The Child Health Plus program covers children under the age of 19.

Similar to the Family Health Plus program, there are family size and income limitations to determine if the child is eligible for coverage. Families of eligible children pay a nominal monthly premium.

For example, a child living in a 5 family member household with a monthly income of $4,997 means the family child health insurance premium would be $9 per child (maximum $27 per family). As the family income increases, the more the family pays in child health insurance premiums. No matter how many children in the family, the maximum monthly premium would not exceed the cost of paying for 3 children.

How to Apply for Coverage

Applicants can visit the New York State Department of Health website and download the necessary application along with the documentation checklist. However, in order to complete the process, applicants must schedule a face to face interview. At the time of the interview, the enrollment facilitator will review the application, review the necessary documentation and discuss the enrollment process and answer questions.

The interview process takes approximately an hour. After the interview, applicants will be notified via US mail as to whether or not their application is approved. The time between the interview and final approval can take as long as two months. Therefore, anyone who is thinking about applying should begin the process as soon as possible

Upon approval, a member ID card is mailed along with the necessary information regarding how to begin using the health benefits. Once accepted into the program members must renew the program each year. Failing to provide the necessary information in the time allotted for the renewal will result in coverage termination.

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About the author: Felicia A. Williams is a former insurance broker who is now a freelance writer.

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