General Discussion > Post-FIRE
Any NYers catching FIRE in 2016? Health insurance
Upstate NYer:
Found this press release, looks like it might be a feasible option for people catching FIRE in NYS in 2016...? If your individual income is $23,540 or less.
http://info.nystateofhealth.ny.gov/news/press-release-ny-state-health-announces-expansion-private-health-insurance-coverage-through
Edit: additional details below.
http://info.nystateofhealth.ny.gov/sites/default/files/Attachment%20F%20-%20BHP%20-%20Benefits%20and%20Cost-Sharing%2C%205-15-15.pdf
brooklynguy:
Thanks for the link. More options are always nice. I wonder how the quality of this plan will compare to other marketplace exchange plans, which can also be free or nearly free (after ACA subsidies) for those in the income level sweet spot needed for this new plan anyway.
Also note that there is proposed legislation in the works for NY to implement a single payer, universal coverage system:
http://www.healthinsurance.org/new_york-state-health-insurance-exchange/
brooklynguy:
Bumping this old thread to see if there are any New Yorkers with experience to share regarding NY's "Basic Health Plan" option (described in the links in the OP), which has now gone live and is known as the "Essential Plan." (There is some limited information about the program available at its official website, http://info.nystateofhealth.ny.gov/EssentialPlan.)
As I understand it, the health insurance landscape for early retirees in NY is now significantly different than in most other states. My understanding is that if your income is low enough to qualify for the Essential Plan (below 200% of the federal poverty level), then you are not eligible to obtain subsidized coverage from the ACA marketplace exchange (which otherwise would have been available to you). In other words, if your income is below 200% of the FPL (and you don't qualify for Medicaid), the Essential Plan is your only option for subsidized coverage in NY.
On paper, the Essential Plan looks great -- no deductibles, and very low (or non-existent, if your income is low enough) premiums and copays. Does anyone here actually have an Essential Plan policy?
In particular, is there any intel on the enrollment logistics? With ACA exchange plans, there has been much discussion in the forum re: problems establishing eligibility for subsidies in the first year after retiring (before you have tax records to demonstrate your newly-lowered income). That problem is mitigated by the fact that you can purchase a policy on the exchange at full cost and then get your premium tax credits applied to your tax liability when you file your taxes the following year. However, if you encounter problems signing up for the Essential Plan (despite your actual eligibility), there may be no similar remedy (because, as described above, your eligibility for the Essential Plan disqualifies you from receiving premium tax credits).
jim555:
Premium tax credits do not apply to the Essential Plan or Medicaid since they are not "insurance" in the conventional sense. Both have no "open enrolment" period, they are open all year. I am on NY Medicaid (UHC Community Plan) right now but plan to bump my income up before I turn 55 yo to get to the Essential Plan, which is not subject to estate recovery.
CanuckExpat:
I'd also like to get more information on these plans, or experience from anyone who has enrolled on one.
If I'm reading correctly, the advantage of this plan compared to ACA exchase with subsidy is low to no premiums, and low out of pocket costs, is that correct?
Does anyone have information on what the out of state coverage/network is like for someone who elects to domicile in NY state but spend most of the time travelling?
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