New York State Attorney General Eric T. Schneiderman is encouraging all state residents to compare and re-evaluate their current health care plans (if they already have coverage) as open enrollment begins this Sunday for 2016. His office has just released a brochure, “Shopping for Health Insurance Coverage,” to assist consumers in their decision-making. The brochures may be obtained by contacting the AG’s regional offices.
According to a release by Schneiderman, people need to determine if they are eligible for premium subsidy through the marketplace exchange, as well as make sure their doctors and local hospitals are in individual plans, as well as check whether their prescription medications are included in the health plan’s formulary, as well as what out-of-pocket expense will be and whether any pre-authorizations for treatments are needed.
“Take the time during open enrollment to compare plans, on and off the marketplace, and evaluate which plans will work best for you based on your personal medical needs. This includes the likelihood of needing significant medical care or using particular medications,” he continued.
Other recommendations include calling insurance companies directly if you have any questions regarding coverage, and to be sure to take detailed notes regarding who you called and whom you spoke to, as well as what you discussed. If you run into any problems with the insurance plan after you enrolled, including inaccurate information about what you were led to believe it covered, you can report it to the attorney general’s Health Care Bureau helpline at 800 428-9071.
New Yorkers should also be made aware of the fact that the NY State of Health insurance exchange is unveiling a new plan for low-income residents who do not qualify for Medicaid. Called the Essential Plan, it is expected to benefit more than 470,000 people in the state who may have decided not to buy health insurance in the past because it was still too expensive or who struggled to pay their monthly premiums and deductibles. To qualify, residents must earn between 139%-200% of the federal poverty level, or no more than $23,540 for singles and $48,500 for families. The new plan will also include low-income legal immigrants who have been in the US under 5-years and are ineligible for federal Medicaid. Premiums for the Essential Plan will be $0 abd$20 per adult per month, and there will be no deductibles.
More people may elect to get health insurance for 2016 because penalties for not having it will jump from $325 or 2%of income (whichever is higher) for 2015, to $695 or 2.5% (whichever is higher) for not being covered in the coming year.
Insurers offering the Essential Plan on Long Island include Fidelis Care, Affinity, Empire Blue Cross/Blue Shield (Nassau County only), Emblem Health, Health First and United Healthcare.