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Overpaying for Health Insurance in New York? Here's What You Can Do
If your premium went up again and your coverage didn't, you're not imagining it. Here's the checklist we walk clients through.
Are you getting a subsidy you qualify for?
A surprising number of self-employed New Yorkers buy full-price plans directly from a carrier and never apply through NY State of Health. If your income is under the 400% line, you're leaving money on the table.
Are you paying full price while healthy?
If you're above the subsidy line and in good health, you're paying a guaranteed-issue price for a risk you don't represent. Private shared-network PPOs on MagnaCare PPO price on health and are routinely hundreds less per month.
Is your network the one you use?
Many New York marketplace plans are HMOs centered on one hospital system. If you drive past in-network hospitals to reach your doctor, or travel, you're paying for a network you can't use. A national PPO fixes that.
Is your deductible matched to your usage?
Healthy people on low-deductible plans overpay every month for a deductible they never reach. Moving to a mid-deductible plan plus an HSA is often the right trade.
New York specifics
New York uses pure community rating — a 25-year-old and a 64-year-old pay the same marketplace premium — and the state restricts most non-ACA plans. Private options in New York are narrower than in other states, so the honest answer here is usually a careful comparison, not a promise of savings. New York has no individual mandate penalty, but it has the strictest insurance rules in the country.
We do this review free, in 15 minutes, for anyone in New York. Check your options.