How to Choose a Health Insurance Carrier and Plan

Understanding what type of health insurance coverage fits your needs is important because it will determine access to medical care and coverage costs. Generally, health plans provide coverage for preventive care, diagnostic tests, injuries and illnesses. However, there are differences among the plans. Plans can vary in terms of the benefits offered, how you pay for services, and how you access different health professionals such as specialists and pharmacists.

Before purchasing a health insurance plan, consider taking the following steps:

Step 1: Determine the health insurance option (see our Overview Of Health Insurance) that best fits your needs and budget. Consider whether you, your employees, and/or some family members may be eligible to enroll in either New York State’s subsidized private health insurance program, Healthy NY , or one of the State’s public health insurance programs. The NYC HI Link search tool asks you questions to see if you may meet some of the eligibility requirements for these programs.

Step 2: Research private health insurance plans available in New York City using the NYC HI Link’s search tool. The tool will provide you with a representative sample of the many plans available to you. If you are a small business owner consider the potential value of accessing insurance through a purchasing alliance. If you are a sole proprietor or independent worker explore whether there are quality, affordable health insurance options available to you through an association.

Step 3: Decide which health insurance plan types (see our Overview Of Health Insurance) are best for you and/or your employees. Think about individual and family health care utilization and try to estimate needs for specialists, prescription drugs, well-child care and mental health services. If it is important for you to access specific providers and hospital networks, contact the insurer or your physician to determine whether their services are covered under a plan.

Step 4: Compare the costs (see our Overview Of Health Insurance). Compare the monthly premiums as well as the out-of-pocket expenses such as deductibles, coinsurance and co-payments of different insurance plans. If you are a small business owner, explore the potential cost savings of establishing a Section 125 plan.

Step 5: Learn more about the health insurer you are considering by consulting the New York State Department of Financial Services report on the number of complaints made by consumers available at http://www.dfs.ny.gov/consumer/hgintro.htm.

Step 6:Decide which health plan offers the benefits you want. Then look at our Buy a Plan and Contact a Carrier pages for individuals and small businesses for further information, including how to contact a broker or the insurance carrier, association or purchasing alliance directly to further discuss your options or to enroll in the plan selected or a similar plan.