New York Health Insurance

Since New York is home to the country’s largest city and some of the world’s most prominent financial institutions, it should come as no surprise that state residents have access to a wide range of health insurance options. The Simple Dollar has compiled key statistics, regulations, and eligibility information related to health coverage in the Empire State.

Enter Your Zip Code:

Stats in Your State

The facts and figures below are provided to help readers in New York compare their insurance quotes with those found elsewhere in the country, and determine whether or not they are paying too much for health coverage.

Chip Medicaid

In terms of residents covered under Medicaid or the Children's Health Insurance Program (CHIP) coverage, New York ranked fifth in the United States behind California, Texas, Florida, and Illinois. Medicaid enrollees rose by roughly 80,000 between 2009 and 2010, while young people covered by CHIP increased by about 7,000 during that same period.

Individual Health Insurance Premiums

In terms of employer-based health plans, the average New York worker paid $1,150 per year — $60 higher than the national average for coverage. However, New York ranked third among the mid-Atlantic states; employees in Maryland and New Jersey paid higher health insurance premiums on an annual basis.

Family Health Insurance Premiums

In 2011, the average New York family covered under an employer-based insurance plan paid an annual premium of $3,824. This was roughly $140 lower than the national average, while employees in two other mid-Atlantic states — Delaware and Maryland — paid at least $500 more on average per year. Families of workers in New Jersey and Pennsylvania, on the other hand, paid less than those in New York.

SAHIE Health Insurance Uninsured

In 2010, 2,245,437 New York residents (or roughly 21.3 percent of the state's population) did not possess health insurance coverage. In terms of total uninsured persons, New York ranked fourth nationwide behind California, Texas, and Florida. However, in terms of statewide percentage of people without health coverage, New York ranked 35th out of 50.

Rules in Your State

In order to receive the proper amount of health coverage in New York, as well as ensure your provider is doing everything by the book, you should thoroughly research the state's insurance laws. Please consult the following resources for more information.

New York Health Care Reform Act

Under New York law, third-party insureds and insurance providers support state-funded healthcare initiatives leveraged through monthly or yearly surcharges.

Affordable Care Act – Senate Bill 5800

Enacted in 2011, SB 5800 expands the definition of the term ‘pre-existing condition’ in order to provide coverage for more individuals; increases the age for dependent children; denies insurers the right to implement lifetime or annual coverage limits “of essential health benefits in an individual, group or blanket policy of hospital, medical, surgical or prescription drug expense insurance”; and cuts specific patient appeal requirements, among other provisions.

Alcohol & Your Health Insurance in New York

Losses Due to Intoxication
Health Insurance Parity for Alcohol-Related Treatment
New York law prohibits health insurance providers from distinguishing between substance abuse and other forms of mental illness.
Insurance companies must provide equal coverage and benefits for mental illness and substance abuse as is afforded to individuals who suffer from a physical illness or condition; this applies to deductibles, co-payments, and limits (both annual and lifetime).

Representatives & Resources in Your State

The following resources will help you locate information about New York insurance laws, file complaints against insurers, and access various health care services for adults, children, and senior citizens.

New York Department of Financial Services
One State Street
New York, NY 10004-1511
Get Directions
The state of New York does not have an official insurance department, so the NYDFS handles all matters related to health coverage (as well as other types of insurance).
How to File a Health Insurance Complaint
This page enables citizens to file an official grievance against an insurance provider that has overcharged them, unfairly altered their policy, or otherwise mishandled their account.
Background of Prior Approval: Health Insurance Premiums
Under New York’s ‘prior approval’ law, the Department of Financial Services must assess and approve any health insurance premium increases before they go into effect.
System for Electronic Rate and Form Filing (SERFF) Instructions
Web users may use SERFF to submit an electronic health insurance application.
Child Health Plus Rate Filing Instructions
Parents or guardians of children who are eligible for Child Health Plus should review this set of guidelines.
Selected New York Health Regulations
These state codes, rules, and regulations cover a wide range of health-related topics, including health insurance standards, enrollment policies, and other stipulations.

Community Health Care Association of New York State
535 8th Avenue, 8th Floor
New York, NY 10018
Get Directions
(212) 279-9686
This organization aims to provide every New York resident with the proper level of healthcare, particularly those who are uninsured and cannot afford medical treatment.

Health Care Association of New York
One Empire Drive
Rensselaer, New York 12144
Get Directions
(518) 431-7600
The mission statement of this organization is “to advance the health of individuals and communities by providing leadership, representation, and service to health care providers and systems across the entire continuum of care.”

New York Department of Health
Corning Tower # 503
Albany, NY 12237
Get Directions
(518) 473-8600
The official website of the NYDOH provides information about statewide health initiatives, wellness programs, and resources for individual and family medical care.

New York State Association of Health Care Providers
20 Corporate Woods Blvd., 2nd Floor
Albany, NY 12211
Get Directions
(518) 463-1118
This trade association is comprised of more than 400 providers of home treatment, long-term health care, and other assistive medical services.