Now that you’ve enrolled in a health plan through NY State of Health, you may have some questions about how to use your health plan coverage. Here are some resources with answers to the questions you may have:
Qualified Health Plans offered in NY State of Health are available in four easy-to-compare metal tiers (platinum, gold, silver and bronze). All plans on the Marketplace cover doctor’s visits; hospital stays; emergency care; maternity and newborn care; mental health and substance abuse disorder services; prescription drugs; rehabilitative and habilitative services and devices; laboratory services; preventive and wellness services, chronic disease management and pediatric dental and vision. Preventive care such as routine office visits and recommended screenings are free.&nb
The Essential Plan is a new program for eligible New Yorkers enrolling in coverage through the NY State of Health. The Essential Plan covers all of the essential health benefits covered under the Qualified Health Plans offered on the Marketplace, including inpatient and outpatient care, physician services, diagnostic services and prescription drugs among others, with no annual deductible and low out-of-pocket costs. Preventive care such as routine office visits and recommended screenings are free. Eligible consumers will pay eit
In-Person Assistors (IPAs)/Navigators provide in-person enrollment assistance to individuals, families, small businesses and their employees who would like help applying for health insurance through the Marketplace.
Welcome to the NY State of Health Assistor Tool Kit.
The administrative guide below will provide information for agents, brokers, and other assistors as they help small groups enroll through the Marketplace. It provides general guidance and defines important policies. The guide may be downloaded and printed or used as a desktop resource.
Following the guide are specific tools and resources that are referenced in the guide, sorted by category. Many of these documents can also be downloaded and printed.