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Health Insurance Basics

Today, most people are required to have some form of health insurance. If you don’t have insurance, you face a financial penalty – and the risk of paying for all of your medical bills in the event of an unexpected accident or illness.
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As part of health care reform, you may be eligible for help paying for your plan.

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Health insurance works like this: you pay monthly for a plan, just as you would for cable or Internet service. Then when you go to the doctor, fill a prescription or get a medical service, like an X-ray for example, the type of plan you have sets the amount you pay.

When health care reform went into effect, it established different levels of coverage that health insurance companies must offer. Each bronze, silver, gold and platinum level of coverage offer the same benefits - the difference is in how much you pay for your care.
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There are two times when you can buy health insurance.

Open Enrollment - starts November 15 and runs through February 15, 2015. To talk to one of our dedicated Insurance Advisors today about your options, call 1-888-679-7105.

Special Enrollment Periods - When you experience certain life events, you may qualify to buy or change your health insurance coverage outside of the annual open enrollment time period. Those events include things such as having a baby, getting married or divorced, moving from one service area to another, or losing coverage from your employer. If you have a special enrollment period, you have 60 days to enroll in a plan.

If you are a Native American, or if you notify us within 60 days of a life-changing event, you may qualify for a special enrollment period.

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Where to get Health Insurance
  1. Through your employer or a spouse’s employer.
  2. Through a government health plan such as Medicaid or Medicare.
  3. Through a company such as Excellus BCBS or the NY State of Health Marketplace.

If you don’t have coverage through an employer, we can help you find the best option. You can meet with someone face-to-face, or talk to someone over the phone.

For helpful tips and information that will help make shopping for insurance easy, download our free Guide to Shopping for Health Insurance.

We're here to help you understand the plan you choose. Here are answers to frequently asked questions once you’ve enrolled.

  1. What can I expect after I enroll?
    The first thing you need to do is pay your first month's premium. Once you pay your premium, you will receive your ID card(s) followed by a member welcome kit.
  2. What if my personal information changes (family size, income amount, address)?
    A good rule of thumb if you enrolled on the NY State of Health Marketplace is to report any change to the NY State of Health Marketplace within 30 days. If you enrolled directly with us, just call the number listed on the back of your ID card.
  3. What if I have questions about my benefits?
    You will receive a welcome kit shortly after you enroll. You can also register for an account at to see details about your benefits and claims online. We offer exclusive member benefits such as coupons, discounts, ExerciseRewards and a 24/7 Nurse Call Line. If you have additional questions, call the number listed on the back of your ID card.
  4. When can I get a new plan or change my coverage?
    Every year, you have the option to purchase or change your plan. For 2015, this time period runs from Nov. 15, 2014, to Feb. 15, 2015. Outside of that, if you experience certain life events, you may be qualified to change your coverage or enroll in coverage. Some of those events include having a baby, getting married or divorced, or losing coverage under another plan. If you have a special enrollment period, you have 60 days to enroll in a plan.
  5. I signed up, but have questions about my application, ID cards or something else. What do I do?
    Call Customer Care at 1-877-626-9298. They can also let you know if any additional information is needed to process your application and start your coverage.

Need Help?

We can help you get coverage.
Call: 1-888-679-7105  Hours TDD/TTY: 1-800-421-1220

Mon. - Thurs. 8 a.m. to 7 p.m
Friday 9 a.m. to 7 p.m.

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