- Associated Press - Friday, October 30, 2015

ALBANY, N.Y. (AP) - Enrollment for the New York Health Exchange reopens Sunday with a new insurance option for thousands of adults who don’t qualify for Medicaid but have been unable to afford private coverage.

The Essential Plan has no annual deductible that patients have to pay before insurance begins paying their medical bills. It also offers the same benefits as other coverage for doctor visits, tests, prescription drugs and hospital care. It includes free preventive care such as doctor exams and screenings, health officials said.

Premiums are free for those with incomes at or below 150 percent of the federal poverty level. Monthly premiums are $20 for those with annual incomes up to 200 percent of the poverty level, $23,540 for a household of one and $48,500 for a household of four, officials said.

“We are excited to be among the first states in the nation to implement this option,” Exchange Executive Director Donna Frescatore said in announcing the option this year.

Adding it to the other options already available “will make coverage even more affordable for hundreds of thousands of New Yorkers,” she said.

Sixteen insurers are offering health plans through the exchange in at least some regions of the state for next year. Thirteen insurers are offering the Essential Plan, while eight are offering coverage for small businesses. Ten insurers are offering stand-alone dental coverage. Open enrollment starts Sunday.

New York’s exchange opened two years ago under the Affordable Care Act, the federal law intended to expand coverage nationally to millions of uninsured people.

It already provides tax credits to subsidize costs for lower-income people who don’t have access to coverage at work. It also links to Medicaid, government-funded health coverage for low-income residents.

About 2.1 million New Yorkers enrolled during its first two years, the Department of Health reported. They included about 415,000 people who joined one of more than a dozen commercial and nonprofit insurance plans available, nearly 1.6 million who signed up for Medicaid and nearly 160,000 who joined Child Health Plus.

Most were uninsured previously, and three-quarters of the individuals and families who signed up for private insurance got tax credits to offset the cost, averaging $220 a month this year, the department said.

Among New York’s nearly 20 million people, data from last year showed 1.7 million remained uninsured, including 138,000 children, said Lorraine Gonzalez-Camastra, director of health policy for Children’s Defense Fund-New York.




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