New York health insurance questions, answered.
Answers from licensed agents about buying your own coverage in New York, organized by topic.
Getting started
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Open enrollment through NY State of Health runs from November 1, 2026 to January 31, 2027. That is about two weeks longer than HealthCare.gov states. Last year the state asked people to sign up by December 15 for coverage starting January 1.
No. New York uses community rating, so insurers cannot charge adults more based on age, health or tobacco use. Your price depends on the plan, where you live and whether you are covering just yourself, a couple or a family.
Yes. On July 1, 2026, New York ended the expansion that covered people between 200% and 250% of the poverty level, after federal funding was cut. About 450,000 people moved to regular marketplace plans. The Essential Plan still covers adults up to 200% of the poverty level with no premium.
Leaving a job
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If the plan was fully insured, you can keep it for up to 36 months in total, through state continuation or federal COBRA plus a state extension. Self-funded plans only get the federal 18 months. You pay the full premium yourself.
When you first lose job-based coverage, you get a special enrollment period, usually 60 days, to choose a marketplace plan instead. Dropping COBRA voluntarily later in the year usually does not open a new window, so you would wait for open enrollment.
If your income is up to about 138% of the poverty level, you may qualify for Medicaid. Up to 200%, you may qualify for the Essential Plan, which has no premium or deductible. Both accept applications any time of year.
Early retirement
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Not in New York. Insurers here charge the same base premium to all adults for the same plan and area, so you pay what a 30-year-old would pay. In most other states, older adults can be charged up to three times more.
Yes. The enhanced federal credits ended after 2025, so households above 400% of the poverty level get no federal premium help for 2026. Managing how much income you report, such as retirement account withdrawals, can matter a lot.
Yes, if you are 19 to 64, your income is up to 200% of the poverty level (about $31,920 a year for one person in 2026) and you do not qualify for Medicaid, Medicare or affordable job-based coverage. It has no premium and no deductible.
Self-employed
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No. New York does not have its own individual mandate or tax penalty. You can still face large bills if you go without coverage, so it is worth comparing your options.
NY State of Health bases your tax credit on your expected income for the year. If your income changes, update your application so your credit matches. Any difference is settled when you file your federal taxes.
Somewhat. Every insurer must offer a standard plan design at each metal level in each county it serves, and many also offer up to two of their own designs. Standard plans let you compare insurers on price and doctor networks.
Short-term plans
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No. New York prohibits short-term limited duration plans because state law requires comprehensive, guaranteed renewable coverage. Federal changes to short-term rules do not override that ban.
You can use state continuation or COBRA from your last job, a NY State of Health plan during open enrollment or a special enrollment period, or the Essential Plan or Medicaid if your income qualifies. All of these cover pre-existing conditions.
Federal rules set a minimum standard, but states can be stricter. New York's insurance law requires medical policies to be renewable at your option and to include full benefits, which fixed-term plans do not meet.
Non-ACA options
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No. Sharing ministries are not insurance and do not have to pay your claims. They have no required reserves, and if there is a dispute, state insurance regulators may not be able to help.
No. New York does not have a Farm Bureau health plan like the ones in Tennessee or Texas. Every individual medical plan sold here must meet full state and federal coverage rules.
No. Federal premium tax credits only apply to plans bought through NY State of Health. Sharing ministries and other non-insurance options do not qualify.
Insurers
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Twelve: CDPHP, EmblemHealth, Anthem HP, Excellus, Fidelis Care, Healthfirst, Highmark, Independent Health, MetroPlus, MVP, Oscar and UnitedHealthcare. Each sells only in certain counties, so your choices depend on where you live.
State regulators approved an average 6% increase for individual plans in 2027, down from the 20.6% insurers asked for. Results ranged from a 3.1% cut for Anthem HP to a 12.2% increase for Excellus and Highmark. What you pay after subsidies can differ.
No. Aetna is not among the twelve insurers selling individual plans through NY State of Health for 2026.
Sources
Reviewed October 2026. Rules and prices change every year; a licensed agent will confirm what applies to you.
- NY State of Health: Open enrollment for 2026 coverage (press release)
- NY State of Health Outreach Tool Kit (2027 open enrollment dates)
- healthinsurance.org: New York health insurance marketplace
- healthinsurance.org: New York state guide
- KFF: Recent changes to Marketplace premium subsidies
- NYS Department of Health: Federal approval to preserve health coverage (March 23, 2026)
- New York Focus: What to do if you are impacted by changes to the Essential Plan
- KFF: Status of state Medicaid expansion decisions
- NY DFS: State continuation coverage extension to 36 months
- NY DFS Insurance Circular Letter No. 7 (2018): Short-term limited duration plans
- U.S. Department of Labor: Statement on short-term limited duration insurance (August 7, 2025)
- Georgetown CHIR: What do you know about health care sharing ministries?
- KFF: Individual market rating reforms (New York)
- NY DFS press release: 2027 health insurance rate decisions (September 4, 2026)
- Finger Lakes 1: New York cuts 2027 health insurance rate requests
- HealthCare.gov: COBRA coverage and the Marketplace
See what you'd actually pay.
A licensed agent will compare plans from every insurer in your New York county, check your subsidy, and walk you through the options. No cost, no obligation.