Healthy NY (Commercial) - Eligibility and Cost

How  do I know if I qualify for Healthy NY insurance?

You must meet the following Healthy NY eligibility requirements:

• You must live in New York State.
• You or your spouse must have a job, or have had a job in the past year.
• Your employer does not “provide” you with health insurance right now.
• “Provide” means offering health insurance AND paying some or all of the costs.
• You have not had health insurance for the past year.
• You have lost insurance because of a “specific event.”

What is a specific event?

• Loss of your job
• Death of a family member
• Change to a new job
• Change of residence
• Group health plan has ended
• COBRA coverage has ended or been cancelled
• Public health insurance program (such as Medicaid or Family Health Plus) has ended
• Legal separation, divorce, or marriage annulment
• You no longer qualify for group health insurance coverage.
• You have aged off your parents' health insurance coverage.
• You must not qualify for Medicare, due to age or disability.
• Your current total (before taxes) monthly household income meets the income guidelines of the program (see chart below).
   

Healthy NY Income Guidelines*

Sole proprietors and independent contractors may subtract documented monthly business expenses when calculating total monthly income.

* = How to Count Your Household Size

Who to count:

• Yourself
• Your spouse, if your spouse lives with you
• Dependent children, whether they live with you or not
• Pregnant women count as two people

Note: Count all of these people even if they will not be on your policy.

Do not count:

• Parents
• Roommates
• People who do not depend on you for support

If your income or job status changes mid-year, your Healthy NY coverage will not end. You will have to show proof of income every year when you renew your insurance.

This grid will reflect your monthly payment if you meet all eligibility criteria:

> Download enrollment application

Need help understanding if you qualify for Healthy NY? Give us a call, or visit one of our community offices.