New York Attorney General Letitia James is urging residents to review their health insurance options and be on guard against scams as major changes to the state’s Essential Plan take effect next month.
Beginning July 1, approximately 450,000 New Yorkers with household incomes above 200 percent of the federal poverty level will no longer qualify for the Essential Plan, a low-cost health insurance program offered through the Affordable Care Act marketplace.
The change stems from federal funding cuts and will affect individuals earning between $31,920 and $39,900 annually, as well as higher-income households that fall within the affected eligibility range.
In guidance released Monday, James encouraged impacted residents to explore their coverage options through the New York State of Health marketplace and reminded them that losing Essential Plan coverage qualifies them for a special enrollment period. Those affected will have until Sept. 1 to enroll in a new health insurance plan.
“New Yorkers deserve clear, reliable information as they make decisions about their care,” James said in a statement. “No one should be left with unexpected medical bills or pushed into a plan that does not meet their needs because they did not know where to turn.”
The Attorney General’s guidance explains the differences between health insurance plans, including HMOs, PPOs, EPOs, and Point of Service plans, and encourages consumers to compare provider networks, prescription coverage, deductibles, premiums, and overall costs before selecting a plan.
James also noted that Affordable Care Act marketplace plans are generally more expensive than the Essential Plan and could become costlier as federal subsidies expire.
The guidance includes a warning about health insurance scams. Consumers are advised to be wary of anyone pressuring them to enroll immediately, requesting payment to renew coverage, promising unusually generous benefits, or seeking personal information without proof they are authorized to assist with enrollment.
State-certified enrollment assistors, navigators, facilitated enrollers, and local government representatives remain available to help New Yorkers review their options and enroll in coverage.
For those who cannot afford marketplace plans, James encouraged residents to explore hospital financial assistance programs, prescription drug assistance programs, discount drug cards, and other available resources.
