Who is eligible to enroll into commercial insurance plans on New York’s “exchange” or “marketplace?”

There are income limitations to enroll into a QHP product. One can purchase a QHP product as long as they:

  • Live in New York State
  • Are between the ages of 18 and 64 (or above 64 and not eligible for Medicare)
    • Enrolling subscribers can opt to cover dependent family members from birth through age 29 under their policies depending on the level of coverage they enroll in.
  • Currently not eligible for a public option
  • Are a legal citizen or resident
  • Have household income greater than 138% of the Federal Poverty Level (in 2013, $32,499 for a family of four)
  • Are a small business with 2–50 employees

Nearly 2.7 million New Yorkers under age 65, about 16%, do not have health insurance coverage. The majority of the uninsured are workers and their families. As many as 1.2 million New Yorkers are projected to become newly insured once Health Care Reform takes full effect.