Applications
Healthy NY Enrollment Restriction
For coverage beginning on or after January 1, 2012, applicants for Healthy NY coverage will only be able to enroll in the High Deductible Health Plan (HDHP). Current enrollees will not be impacted by this restriction. Please visit the links below for more detailed information on the change.
Frequently Asked Questions (PDF format)
Below are links to Healthy NY application forms. Each application is in Adobe PDF format (*.pdf), which requires the Adobe Acrobat Reader (version 7.0 or above) to view and print. Applications need to be completed and mailed to the participating health plan of your choice. For a list of premium rates and the names and addresses of health plans in your area that offer Healthy NY, select the link HMOs and Rates by County.
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