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Affordable health insurance for the uninsured and small businesses
Healthy NY is a state sponsored program that offers a comprehensive health insurance benefits package for eligible businesses with 50 or fewer employees. Uninsured workers whose employers do not offer health insurance or sole proprietors can also qualify for coverage.
By enrolling in the Healthy NY program through Excellus BlueCross BlueShield, you will get the security and peace of mind you only get through BlueCross BlueShield.
- Uninsured Individuals - The Healthy NY individual program is available to both eligible working individuals whose employers do not provide health insurance coverage and to eligible sole proprietors. Sole proprietor applicants must meet the same eligibility criteria that are applicable to working individual applicants. If you meet each of the following requirements, you may be eligible for Healthy New York:
- You must be a resident of New York State;
- You must be employed on a full-time, part-time or episodic basis or you must be a sole proprietor;
- Your total gross household income must not exceed the household income limitations of the program (250% of the gross federal poverty level);
- You must be currently uninsured and you must have been uninsured for the previous 12 months (see the exceptions below);
- Your employer must not currently provide group health insurance coverage and must not have provided such coverage during the previous 12 months (see the exceptions below); and
- You cannot be eligible for Medicare.
- Small Businesses - Each of the following requirements must be satisfied in order for a small business to participate in the Healthy NY program:
- The business must have 50 or fewer eligible employees;
- One-third (30%) of the employees must earn $41,250* or less annually;
- The business must not have provided group health insurance coverage to its employees within the preceding 12 months;
- 50% of the eligible employees must participate in the program and at least one participant must earn annual wages of $41,250* or less;
- The small employer and employee share equally in the cost of the premium (though the employer may choose to pay more than 50% of the premium); and
- The business must be located within New York State.
*Adjusted Annually for Inflation
Exceptions to Eligibility Criteria
Exceptions to the above criteria that may allow individuals or sole proprietors to qualify for Healthy NY coverage are:
- Loss of employment
- Change to a new employer
- Death of a family member
- Change of residence
- Discontinuation of a group health plan
- Termination or cancellation of COBRA coverage
- Change in marital status
- Loss of eligibility for group health insurance coverage
- Reaching age limit for dependent coverage
Healthy NY provides coverage for essential health care needs such as inpatient and outpatient hospital services, physician and surgical services, maternity care, preventive health services, diagnostic and x-ray services, emergency services, and a prescription benefit. With over 9,000 quality doctors and specialties to choose from we are certain you will find one that is convenient for you.
Follow the links below to view a Summary of Benefits and Coverage (SBC):
If you are new to Healthy NY, New York State requires you to enroll in the High Deductible Health Plan (HDHP) option. With a high deductible health plan, you pay for most health care expenses until you meet your annual deductible, before the insurance policy begins to cover them. The deductible for 2013 is $1,250 for individuals and $2,500 for families (more than one person).
Follow this link to view the a Glossary.
Call 1-800-499-1275. If you are a Small Businesses, call 1-877-872-9308.
Learn more about Healthy New York at the Healthy New York website.