In the last few years the health insurance carriers have stopped working with brokers in the individual market making it so that we are, unfortunately, unable to provide one-on-one services for individuals any longer. However, we do realize how confusing and overwhelming choosing a health plan can be so we have put together the following information guide to help you navigate the marketplace and find a plan that works for you and your family. We hope that you will find this helpful in your search for the perfect health insurance plan.

PLEASE READ THE FOLLOWING INFORMATION CAREFULLY TO LEARN WHAT PLANS ARE AVAILABLE TO YOU AND HOW TO ENROLL YOU AND YOUR FAMILY.

In order to choose a health plan, the best options available for 2019 are on the NYS Health Exchange. Below are instructions on how to set up an account with them. Once you create your initial account, you will have access to the plan selection area. You can use the Exchange to enroll in an individual plan regardless of your income level during the open enrollment period, which ends on December 15, 2018.

How to enroll in a plan: 

1) Go to https://nystateofhealth.ny.gov/individual and register
2) Confirm your identity by answering personal questions
3) Enter household information, including SSN, DOB, income, etc. for each household member
4) Once your eligibility has been determined you will have access to the plan selection section
5) If you have any issues call the Exchange at 855-355-5777

Here is the list of insurance carriers offering plans on the Marketplace in Suffolk County:

1. Empire
2. Emblem
3. Oxford/United Healthcare
4. Oscar
5. Fidelis
6. Healthfirst

Options to go direct to carrier:

The two insurance providers in our area that are accepting individual applications outside of the Marketplace for 2019 are Oscar and Emblem Health.  If you want to apply directly to either, visit their websites at www.emblemhealth.com or www.hioscar.com/ny

Children:

For children under 19, you can enroll in ChildHealthPlus. Click here to view our informational packet about these plans. They are offered only on the NYS Marketplace

GUIDE TO CHOOSING THE RIGHT PLAN

Most plans offer the same benefits such as drugs, hospital admission, surgeries regardless of deductible, modal tier, etc. So if you have a Bronze, Silver, Gold or Platinum plan with ANY carrier you are going to get the same level of care. The difference is whether you pay for the coverage upfront in premium or to the providers when using your benefits. To simplify, it comes down to two variables:

Q. Does the Network of Doctors work for you and your family?
A. What can work for one person might not for another. Generally speaking, the bigger the network, the higher the premium cost. It doesn’t mean if you have a smaller network the doctors in it are worse or you won’t be able to find care.

Q. Do you want to pay more in premium or more at the doctor?
A. Depending on how much risk you want to absorb will have a direct effect on your premium. You don’t want to overpay the insurance company for something you might or might not use. So if you don’t go to the doctor very often, you may want to consider a plan with a lower premium. However, like the network decision, it is up what works for you in your unique situation.

IN NETWORK HOSPITALS

NUMBER OF DOCTORS IN A 5 MILE RADIUS

UNDERSTANDING HOW YOUR HEALTH INSURANCE PLAN WORKS

What is coinsurance? What does our deductible mean and what is this maximum out of pocket thing? These are all common questions we get in our office when people are looking at the different insurance plans offered. Below is an explanation of these terms to help you understand the plan you’re choosing.