Where Do I Get Care?
Group Policies
You may be able to get group health coverage—either indemnity or managed care—through your job or the job of a family member.
Many employers allow you to join or change health plans once a year during open enrollment. But once you choose a plan, you must keep it for a year. Discuss choices and limits with your employee benefits office.
Individual Policies
If you are self-employed or if your company does not offer group policies, you may need to buy individual health insurance.
Under the new federal Affordable Care Act (ACA), individuals may purchase insurance through state-based marketplaces called exchanges. New Yorkers are able to shop for a health insurance plan to find one that meets their needs, and enroll in available plans through New York’s health benefit exchange, The New York State of Health: The Official Health Plan Marketplace. Through the exchange, individuals will be able to choose from an array of policies that all offer comprehensive benefits and services known as the “essential health benefits” package. Consumers can choose among plans where the insurer pays more or less of the average costs.
Individuals may also be able to purchase many of these policies directly from the different health plans as well.
To get more information on policies available to individuals, access the state’s health benefit exchange website.
Medicare
Americans age 65 or older and people with certain disabilities can be covered under Medicare, a federal health insurance program.
In many parts of the country, people covered under Medicare now have a choice between managed care and indemnity plans. They also can switch their plans for any reason. However, they must officially tell the plan or the local Social Security office, and the change may not take effect for up to 30 days.
For more information on Medicare, visit the Medicare website or contact your local Social Security office or state office on aging to find out what is available in your area.
Medicaid
Medicaid covers some low-income people (especially children and pregnant women), and disabled people. Medicaid is a joint federal-state health insurance program that is run by the states.
In some cases, states require people covered under Medicaid to join managed care plans. Insurance plans and state regulations differ, so check with your state Medicaid office or visit the New York State Medicaid website for more information.