Unemployment: Health Insurance Options
Health insurance is a very important protection for you and your family. Aside from providing coverage for services related to an existing illness or a sudden, unexpected illness, it may also provide coverage for important preventative care to detect illnesses before they become serious. Since many families obtain their insurance coverage through an employer, it is important to know your insurance options should you become unfortunate enough to lose your job.
You have the right to continue your group plan through a COBRA policy. If your group has less than 20 employees, you have a similar right under the NYS continuation of coverage law. You will be required to pay the full cost of the coverage, including any portion your employer formerly paid on your behalf. Your employer should notify you of your right to this coverage upon termination of your employment. If you have not received notice, contact your employer or call this Department for assistance at 1-800-342-3736.
For general COBRA FAQs, please select this link.
Standardized Individual Direct Payment Policies
You may purchase individual health insurance for yourself and your family on a direct payment basis regardless of your health status or income. However, these policies may exclude coverage for certain pre-existing conditions if you have not had health insurance coverage within the past 63 days. It is therefore very important not to wait to purchase this type of policy. Individual direct payment policies are offered by all HMOs in New York State. For a list of the HMOs currently offering these plans in your county and the rates, please select this link, or call 1-800-342-3736.
Healthy New York
The Healthy New York program offers discounted coverage to individuals who have lost group coverage because they have lost their job and meet certain criteria, including income limits. To learn more about the eligibility for this program, please visit the site at http://www.healthyny.com, or call 1-866-HEALTHY-NY.
Child Health Plus
Child Health Plus is a program run by the NYS Department of Health. The program provides free or low cost health insurance coverage to children under the age of 19 whose families meet the program’s income guidelines. To find out more about the Child Health Plus program and its eligibility criteria, you may call 1-800-698-4543, or visit the Web site at: http://www.health.ny.gov/health_care/child_health_plus/index.htm.
Family Health Plus
This program provides coverage for adults meeting certain income requirements. For more information on the Family Health Plus program and its requirements, please visit the Web site at: http://www.health.state.ny.us/nysdoh/fhplus/index.htm.
Other Individual Policy Options
Several New York insurers offer health insurance options to individuals in addition to the direct payment products discussed above.
- Group Health Incorporated (GHI) offers two products, GHI
Alliance Value and GHI Alliance 365, in this market.
- GHI Alliance Value provides coverage for inpatient hospital care, prescription drug coverage, maternity and well child care and certain preventive care. The plan does not cover physician visits, other than for well-child or maternity.
- The GHI Alliance 365 hospital plan covers inpatient stays, including mental health and certain types of outpatient care such as mammography and cervical cytology. Physician office visits and prescription drugs are not covered.
- Both plans are available statewide.
- To contact GHI, go to www.ghi.com or call 212-501-444 in New York City, 315-432-0826 in Syracuse, or 1-800-624-2414 in other areas.
- Empire Blue Cross Blue Shield also offers hospital only health insurance in the 28 counties in which it does business. These counties are in the metropolitan New York City region, the Mid-Hudson region and the Albany/Capital District region. Empires TraditionPLUS covers inpatient stays and limited outpatient services. To contact Empire, go to www.empireblue.com or call 1-800-662-5193.
- Excellus Health Plan offers individual hospital and medical indemnity contracts. There are separate hospital and medical contracts available in the Central New York and Utica-Watertown regions. The hospital and medical benefits are provided under the same contract in the Rochester region. To contact Excellus, visit www.excellusbcbs.com or call 1-800-633-6066 in Central New York, 1-800-847-1200 in Rochester, and 1-800-765-5226 in Utica.