Medical insurance advice- NY

amother

Tangerine

Tue, Dec 15 2015, 10:52 am

We are moving to NYC.
We have 3 children. DH is self employed earning approx 150k a year. He will continue his business there so income may go up/down a bit.
We will need to get our family onto a health plan as soon as we settle in our home.
Can anyone recommend the best plan for us?
Where can I inquire?
Anybody with our income and family size who can chime in?

supty

Tue, Dec 15 2015, 11:27 am

Now is open enrollment on the ny health exchange. You can go online and fill out info about your family and income and you will be offered plans with reduced rates based on how much youre making/family size. It's a pretty simple process. It's probably a good idea to find out which plan is best for the specific area you're moving to based on the doctors you will be using.

Good luck!

amother

Tangerine

Tue, Dec 15 2015, 12:00 pm

supty wrote:

Thank you.
I'm not sure what that is, can you explain?
Are those private insurances or govt funded?

twogees

Tue, Dec 15 2015, 12:07 pm

I believe they are both. I would possibly call up the ny health exchange. they will be ablr to answer any questions you have. I did my insurance (for me and my baby-gt for ds while pregnent) on the phone and I found it to be VERY helpful. There may be places in the area you are moving to that can help you get insurance-where I live there is achiezer and the jcc.

kiwi strawberry

Tue, Dec 15 2015, 3:55 pm

Their number is 855-355-5777 and the website is my.ny.gov. If you want to be covered by January 1st you need to choose a plan by December 19th, 4 days from now, but open enrollment lasts through the end of January (you just won't be covered until February or March). However, you are allowed to get a new plan at any time of the year if you have a qualifying life event, and moving may be a qualifying event. If it is then you may want to wait until after the 19th to call because their call volume is super high now from everyone who is trying to pick a plan now before the deadline (over an hour wait on the phone), unless like I said you want coverage by January in which case you'd have that same Dec. 19th deadline. Enjoy the tedious process and hatzlacha picking a plan that's right for your family!

HonesttoGod

Tue, Dec 15 2015, 4:08 pm

Where in NY are you living?
You can find a center that assists with enrollment for NY Health Marketplace.
Personally I used Yeled Vyalda in Boro Park. They were extremely helpful.

I also just found out about an insurance for NY (I understand it is mainly for NYC) called Oscar. Their prices are pretty competitive and it seems that they work out at a pretty good rate/deal.
Google oscar insurance and their website is very explanatory.

Amarante

Tue, Dec 15 2015, 4:59 pm

Get a broker who can recommend the best insurance for you.

Unless there is more to your financial picture, it is unlikely yah a family of 5 with an income of $150,000 would qualify for a subsidy. I believe the subsidies end at about $96,0000 but this is MAGI which is a form of modified adjusted gross income. You should check with your accountant of course.

You can still buy through the exchange but f you won't receive a tax subsidy, you don't have to. If you receive a subsidy, you have to purchase through the exchange.

Again, I would urge you to use an experienced broker who is familiar with the plans and can advise you in the best for your circumstances. Very very roughly, you can choose between lower premiums and higher deductibles and co-pays or higher premiums and lower deductibles. Also threw into the mix, that wider networks generally are more expensive and HMO plans are less expensive than PPO or EPP type of plans.

Moving is generally a life event since insurance is a state regulated industry and one is generally only able to use medical services within the state you purchased insurance in.

But again, your best advice is to find a knowledgeable broker who will be familiar with networks.

amother

Pumpkin

Tue, Dec 15 2015, 7:22 pm

Since you won't qualify for a subsidy you may as well use a broker. There are some plans that a broker has that are not on the exchange.

My husband is also self employed. Unless your husband's business qualifies for business insurance (does he have a full time employee he would offer insurance to) you are only able to purchase HMO's.

There are not too many great options as far as I can tell.

Amarante

Tue, Dec 15 2015, 7:27 pm

amother wrote:

You can use a regular insurance broker and purchase on the Exchange. The broker makes his commission based on the actual cost of the premium before subsidy so it's still a lucrative field.

I bought my policy through California Care using a very good regular broker. His commission was his concern but it didn't impact what I was paying for the insurance since the insurance company paid him.