Best Health Insurance in New York 2021

Last modified: September 8, 2021

New York (NY) is the 4th most populous state in the USA. It has a population of 19.45 million residents. According to recent statistics, 9.54 million of these residents (49 percent) receive their health insurance from their employers. The rest purchase their health insurance through private insurance providers or government-assisted health insurance plans.

New Yorkers can purchase their health insurance plans through the best health insurance companies listed on the NY Health Insurance Marketplace. Buyers simply have to enter their personal information like their zip code, age, average monthly income, number of dependents, and answer a few simple questions about their medical history to enroll in a private health insurance plan. Due to the Covid-19 pandemic, the next round of enrollments has been extended until January 31st, 2021. This is to ensure that another 1.8% of the residents can have health insurance in 2021.

Also, if anyone was unable to apply for it during the fixed deadline of November 1st to December 15th, 2020, they have the chance to enroll in one of the best health insurance plans in New York until January 31st.

For residents who are unable to afford private health insurance and do not have access to employer-provided health insurance, the government-assisted insurance plans can be purchased from the State Marketplace. You can directly apply through the website by clicking on the ‘Enroll’ button. The government-assisted Medicaid, Child Health Plus, and the Essential health insurance plans are available throughout the year. Small businesses, individuals, and families are all eligible for these government-assisted health insurance plans.

In this article, we will give you a detailed review of the best health insurance companies in New York. We will analyze and compare the health plans of all the health insurance providers to give you a complete guide to buying the best health insurance plans in New York. You can also check for our best health insurance companies list to help you make a sound decision.

List of Providers and Comparison of Plans

There are a number of private health insurance companies in NY providing affordable health insurance plans. We have listed some of the most popular New York health insurance providers and their plans below:

  • Capital District Physicians’ Health Plan (CDPHP)
  • Emblem (Health Insurance Plan of Greater New York)
  • Health Plus HP (Empire)
  • Excellus
  • Fidelis (New York Quality Health Care Corp)
  • Healthfirst PHSP
  • HealthNow New York (BCBS of Western NY and Blue Shield of Northeastern NY)
  • Independent Health Benefits Corporation
  • Metro Plus Health Plan
  • MVP Health Plan
  • Oscar
  • UnitedHealthcare of New York

In the NCQA’s Health Insurance Plan Ratings of 2017-2018, Capital District Physicians’ Health Plan (CDPHP) and Capital District Physicians’ Healthcare Network Inc. (CDPHN) had the best overall rating. The results are presented below:

According to a recent report, New York has the 15th best healthcare system in the USA. New Yorkers spend around $9,788 on their health insurance every year. This is almost $1,700 more than the national average spent on health insurance per state.

It is important to understand that New York is a densely populated state with a culturally diverse population. It is frequented by tourists across the year. It is a commercial hub and has a higher cost of living as compared to the other states. People living in New York even earn more than the national average. All these factors contribute to the pricing of health insurance plans.

However, the pricing for monthly premiums primarily depends on the type of plan and the age of the insurers. In New York, residents can choose from one of these private health insurance plans and pay their monthly premiums accordingly.

  • Catastrophic
  • Bronze
  • Silver
  • Gold
  • Platinum

From the graph above, it can be seen that the monthly premium for the catastrophic plan bought by an adult is $287.

The catastrophic plan is the basic health insurance plan that covers the medical costs for emergencies and accidents. It gives you coverage for basic healthcare services like vaccinations, health screenings, annual check-ups, and in case you require contraceptives. Although catastrophic plans have the lowest monthly premiums, the annual deductibles for them are the highest.

On the other hand, the platinum plan has the highest monthly premium of $1,064 for an adult individual but the yearly deductibles for the platinum plans are the lowest – as has been explained in the table below:

To explain simply:

  • The Bronze level gives you 60 percent health coverage
  • The Silver level gives you 70 percent health coverage
  • The Gold level gives you 80 percent health coverage
  • The Platinum level gives you 90 percent health coverage

 

Moreover, it is observed that residents of New York will be paying an average of $701 on their monthly premiums for the year 2021. This is 1% higher than what they were paying in 2020.

However, a large number of people in New York rely on government-assisted health insurance plans that are available at the federal and state level. On the federal level, people can enroll in the Affordable Care Act (ACA), which is also known as Obamacare. Currently, 796,000 people in New York receive their health insurance from the ACA-created BHP covering known as the Essential Plan.

The rest of the people have health insurance plans through the Medicaid or Medicare programs.

Cheapest Health Insurance Plan by Cities in New York

As we mentioned above that Fidelis Care, Silver is the cheapest health insurance in NY. But let’s take a look at the city-wise breakdown to understand what health insurance plans are the cheapest in the popular cities of NY.

1.   New York City

New York City (NYC) has a population of over 8 million. It is one of the most multicultural cities in the world with a diverse population. Being a commercial and cultural hub of the USA, it is no wonder that the overall monthly premiums of all the health insurance plans are higher in NYC than the national average.

However, the most affordable health insurance in NY city is the Fidelis Care Bronze HSA, Bronze, ST, INN, Fidelis Care HBX Network plan. The monthly premium for this plan is $412.68, and its yearly deductible is $6,100.

 

2.   Buffalo

The city of Buffalo has a population of over 256,304. It is the 2nd most populous city in the state of NY. 

The cheapest health insurance plan in Buffalo is the Fidelis Care, Catastrophic, ST, INN, Fidelis Care HBX Network plan. The monthly premium of this plan is only $157.

In the bronze category, the cheapest health insurance plan for an adult individual is the Fidelis Care Bronze HSA, Bronze, ST, INN, Fidelis Care HBX Network plan. The monthly premium for this plan is $345, and its yearly deductible is $6,100.

 

3.   Rochester

The city of Rochester has a population of over 206,284. It is the 3rd largest city in the state of New York.

The cheapest health insurance plan in Rochester is the Fidelis Care Bronze HSA, Bronze, ST, INN, Fidelis Care HBX Network plan. The monthly premium for this plan is $378, and its yearly deductible is $6,100.

 

4.   Yonkers

The city of Yonkers has a population of over 199,663. It is the 4th most populous city in the state of New York.

The cheapest health insurance plan in Yonkers is the Fidelis Care, Catastrophic, ST, INN, Fidelis Care HBX Network Plan. The monthly premium of this plan is only $214.

In the bronze category, the cheapest health insurance plan is again the Fidelis Care Bronze HSA, Bronze, ST, INN, Fidelis Care HBX Network plan. The monthly premium for this plan in Yonkers is $470, and it has a yearly deductible of $6,100.

 

5.   Syracuse

The city of Syracuse has a population of over 142,749. It is the 5th most populous city in the state of New York.

The cheapest health insurance plan in Syracuse is the Fidelis Care, Catastrophic, ST, INN, Fidelis Care HBX Network Plan. The monthly premium of this plan is only $186.

In the bronze category, the cheapest health insurance plan is again the Fidelis Care Bronze HSA, Bronze, ST, INN, Fidelis Care HBX Network plan. The monthly premium for this plan in Yonkers is $408, and it has a yearly deductible of $6,100.

 

6.   Albany

The city of Albany has a population of over 97,279. It is the 6th most populous city in the state of New York.

The cheapest health insurance plan in Albany is the Fidelis Care, Catastrophic, ST, INN, Fidelis Care HBX Network Plan. The monthly premium on this plan is only $188.

In the bronze category, the cheapest health insurance plan is again the Fidelis Care Bronze HSA, Bronze, ST, INN, Fidelis Care HBX Network plan. The monthly premium for this plan in Yonkers is $412, and it has a yearly deductible of $6,100.

 

The results above indicate that in all the 6 major cities of New York, the Fidelis Care Bronze HSA, Bronze, ST, INN, Fidelis Care HBX Network plan is the cheapest health insurance plan in the Bronze category.

 

Average Cost of Health Insurance by Family Size in New York

The average cost of health insurance in NY is $701, which is around $200 more than the national average.

According to the health insurance quotes in NY, the average monthly cost of a premium family health insurance plan is $1,894. This is considered to be the cheapest low-income health insurance in NY.

If you are considering opting for a family health insurance plan, you must bear in mind that the size of your family and the ages of all family members will have an effect on the monthly premium.

In the table below, you can see the average monthly premium on health insurance plans in New York according to the family size.

 

New York Health Insurance Guide and Resources

In the state of New York, there are 3 main types of health insurance providers:

  • Health insurance provided by your employer
  • Private health insurance in NY for individuals and families
  • Government-assisted health insurance

According to recent statistics, only 5% of the population in New York is uninsured. In fact, in a study conducted by US News, it was found that the state of Oregon has the 15th best health insurance in the USA. The 3 different types of NY health insurance providers and their numerous health insurance plans ensure that everyone in NY has access to affordable healthcare.

1.   Employer-Provided Health Insurance in New York

Nearly half of all residents in New York have employer-provided health insurance, which covers the medical expenses of the employees and their families. This gives them all the basic benefits of a health insurance plan. These include coverage for:

  • Emergency service
  • Hospitalization
  • Maternity care, delivery, and childcare
  • Healthcare for children
  • Mental health and therapies
  • Treatments for substance abuse
  • Outpatient services and care
  • Medical tests
  •  Accidents and injuries
  • Prescribed medicines and drugs

 

2.   Private Health Insurance Providers in New York

There are many private health insurance companies that provide individual health insurance in NY as well as health insurance for families. The best health insurance companies in NY provide affordable health insurance plans with a number of essential benefits. These can be bought from the NY health insurance marketplace by simply entering your personal details online, such as your postal address, age, average monthly income, and the number of dependents. These online health insurance tools will suggest the best health insurance plans in NY based on your needs.

However, you must keep in mind that most private health insurance providers open their round of applications in the fall. You can apply for the open enrollment between November 1st and December 15th. This is to ensure that as the new year begins, you and your family have insurance from the first day of the year. But due to Covid-19 last year, the deadline for applications was extended until January 31st, 2021.

3.   Government Assisted Health Insurance in New York

You can apply for three different types of government-assisted health insurance in NY. At the federal level, we have the Affordable Care Act (ACA), which is also commonly known as Obamacare. But in NY, the ACA has created a BHP covering known as the Essential Plan.

Currently, only 796,000  residents in NY have access to the Essential Plan. You can directly apply for the Essential Plan through the government portal, Healthcare.gov. You can check the eligibility criteria before enrolling yourself to ensure that you and your family qualify for government-assisted health insurance.

You can also apply for one of the state-level health insurance plans such as Medicaid and Medicare. Almost 26% of people are enrolled in Medicaid in NY, and13% are enrolled in Medicare. You can apply for Medicare or Medicaid through their relevant websites and pick the plan that works for you. For children, there is a special health insurance plan known as Children’s Health Plus coverage.

Most of these health insurance plans cover the costs of the following essential healthcare services:

  • Routine visits to the physicians
  • Primary care
  • Urgent care and emergency room admissions
  • Cancer treatments
  • Blood tests
  • Physical therapies
  • X-Rays

Who Qualifies for Medicaid?

In order to qualify for Medicaid, your household income must be below 138% of the federal poverty rate.

The table below shows the maximum yearly income according to the household size in order to be eligible for Medicaid.

Who Qualifies for Medicare?

Only people who are over the age of 65 and cannot afford private health insurance are eligible for Medicare. If an individual over the age of 65 applied for Medicare, his/ her monthly income should be below $1,456. If a couple where both partners are aged over 65 apply for Medicare, then their combined monthly income must be below $1,960.

 

Who Qualifies for Child Health Plus?

In NY, the households that have children below the age of 19 qualify for the Child Health Plus coverage if their monthly incomes are high for Medicaid, but their income range falls 400% below the federal poverty level.

Families who have Child Health Plus coverage only have to pay a maximum of $60 per child for their monthly premiums.

In the table below, you can see the number of monthly premiums that families have to pay based on the number of children in the household.

 

Tips to Save on Health Insurance in New York

There are several factors that affect the cost of your NY health insurance premium. The best private health insurance in NY will decide your monthly premiums based on these compulsory factors:

Your body mass index (BMI): Obese and underweight people will have higher premiums

  • Tobacco use: If you are habitual to smoking, your premiums will be higher
  • Age: Older people and senior citizens will have higher premiums
  • Location: People who live in dangerous cities and town have higher premiums
  • Cost-sharing reductions: If you qualify for this discount, your premium will be lower
  • Applying as a family or individually: Family plans have lower premiums as compared to individual plans
  • Pre-existing conditions: People who have pre-existing medical conditions have higher premiums.
  • Gender: Women pay a higher premium on their health insurance plans as compared to men
  • Insurance and medical history: If your insurance and medical history are satisfactory, you will pay a lower premium.

 

You can check the best health insurance in NY through the New York health insurance exchange website to find an affordable health insurance plan for you and your family.

Pros & Cons

The Pros

The Cons

Final Verdict

FAQs

When is New York open enrollment for 2021 health insurance coverage?

November 1st to December 15th.

Did New York expand Medicaid?

Yes, in New York, state health insurance programs like the Affordable Care Act, Medicaid, and a Basic Health program were introduced, expanded, and embraced.

Is Health Insurance Mandatory in New York?

No. In New York state, health insurance is not mandatory, but with Obamacare, even those people who cannot afford private health insurance can get access to free health insurance in NY.

What is the income limit for Medicaid in New York?

If you are applying for individual health insurance, then your minimum income must be $16,971 per year for receiving Medicaid in NY. If you are a family of four, then your minimum yearly income must be $36,846 for receiving Medicaid.

What are Short term health insurance conditions?

The short-term health insurance in New York is prohibited as it cannot be renewed and does not cover the basic essential benefits like prescription drugs, mental health, and maternity.

What is the uninsured population rate in New York?

Around 5% of the residents in NY are uninsured.