Bronze, Silver, Gold and Platinum plans that cover all ten essential health benefits — with premium tax credits for about 4 in 5 enrollees.
Not a government marketplace. Health Enrollment Center is operated by Sprinter Insurance Agency LLC.
New York works differently from most states, in ways that favor the consumer. It runs its own marketplace — NY State of Health — and it's one of the few states that offers the Essential Plan, a comprehensive, very low or $0-premium plan for residents who earn too much for Medicaid but still need affordable coverage. Many New Yorkers who'd pay real money elsewhere qualify for near-free coverage here.
Every ACA marketplace plan sold in New York is guaranteed-issue and covers pre-existing conditions, preventive care, prescriptions, maternity, mental health and the rest of the ten essential health benefits. Plans are grouped into metal tiers — Bronze (lowest premium, highest out-of-pocket), Silver (the tier subsidies are calculated against, and the only tier eligible for cost-sharing reductions), Gold and Platinum.
The premium tax credit is what makes marketplace coverage affordable. It's based on your household income relative to the cost of the benchmark Silver plan where you live, so two families with the same income can get very different credits depending on their ZIP code. A licensed agent runs that math with you before you enroll — there is no charge, and the plan price is identical to enrolling on your own.
If your income lands between roughly 100% and 250% of the federal poverty level, a Silver plan also unlocks cost-sharing reductions that quietly lower your deductible and copays. Most people never realize they're leaving that on the table by picking Bronze on price alone. That's the kind of thing a good agent catches.
New York runs its own exchange, NY State of Health, rather than using HealthCare.gov. That matters more than it sounds: state-based exchanges set their own Open Enrollment dates, can recognize special enrollment situations the federal marketplace does not, and sometimes administer state-only programs that have no federal equivalent. Check the NY State of Health calendar rather than assuming the federal dates apply to you. New York runs its own state-based marketplace, NY State of Health, and also offers the low-cost Essential Plan.
In New York the premium tax credit does the work for households above roughly 138% of the federal poverty level; below it the state's Medicaid expansion picks up, and a single application screens for both. For the above-poverty reader the practical point is simply to estimate income accurately — over-shrinking it at application is what accidentally routes people to Medicaid instead of the subsidized plan they were after. New York expanded Medicaid and additionally offers the Essential Plan — a very low or $0-premium option for lower-income residents who earn too much for Medicaid. Between the two, many New Yorkers qualify for comprehensive coverage at little to no cost.
The carriers writing individual business in New York include Fidelis Care, Healthfirst, UnitedHealthcare / Oxford, EmblemHealth, MetroPlusHealth and others. Networks and pricing are set county by county rather than statewide, so the same carrier can be the best value in one metro and the wrong choice an hour away. We quote New York City, Long Island, Buffalo and Albany — and every county in between.
Don't see yours? Call a licensed agent — most answers take under two minutes.
Yes. We help New York residents compare ACA marketplace options against the alternatives so you can see the real trade-offs before you enroll.
The Essential Plan is a comprehensive health plan offered through NY State of Health for residents whose income is above Medicaid limits but still modest. For many enrollees it has a $0 monthly premium, no deductible, and low copays. It's one of the biggest reasons New Yorkers often pay far less than residents of other states — we'll check whether you qualify.
Through NY State of Health, the exchange New York runs itself — not HealthCare.gov. A licensed agent can enroll you in the same plans at the same price. Because New York sets its own calendar, check the Open Enrollment dates against NY State of Health rather than assuming the federal ones apply to you.
The carriers writing individual business in New York include Fidelis Care, Healthfirst, UnitedHealthcare / Oxford, EmblemHealth, MetroPlusHealth and others. Which of them is actually competitive depends on your county rather than the state — the lineup and the networks in New York City are not the lineup in Albany. We are independent and compare across all of them rather than steering you to one company.
Start with your ZIP. Two quick questions, then a licensed agent brings you the plans you actually qualify for — no cost, no obligation.