October 1 marked the opening of the “NY State of Health,” New York’s version of the health benefit exchange – part of the federal Affordable Care Act (ACA). It allows New Yorkers to shop for and compare health insurance packages online. The exchange also makes it easy for people to check their eligibility for health care programs like Medicaid and Child Health Plus and to sign up for these programs if eligible.

Such an expansive marketplace can be daunting, but health care navigators are available to help. Just as one might consult a tax advisor when filing taxes, navigators – designated and certified by the state of New York – can help you find the best insurance plan to fit your needs. Navigators may help remove barriers to the application process by providing assistance in multiple languages, in community-based settings and during non-traditional hours such as evenings and weekends.

By visiting nystateofhealth.ny.gov/agent/hx_brokerSearch or by calling 1-855-355-5777, you can search for a navigator in your area who can provide detailed information on the ACA and the insurance plans available in the marketplace. The NY State of Health allows you to authorize a navigator to work on your behalf or designate a trusted friend, relative, partner or lawyer as an “authorized representative” to handle your application and to act for you on matters related to your application. For more information, visit nystateofhealth.ny.gov/agent/navigators.

For some, coverage will be offered for free or at a reduced cost through tax credits and subsidies. You may qualify for tax credits if you are an individual earning up to $45,900 a year or a family of four earning up to $94,200 a year. Through the marketplace, you may qualify for Insurance Affordability Programs, including Medicaid, Child Health Plus, Advance Premium Tax Credits and Cost-Sharing Reductions, which can lower the cost of your coverage.

Here are some fast facts about NY State of Health:

• Both individuals and small businesses with 50 or fewer employees can use NY State of Health.
• Before NY State of Health, nearly 2.7 million New Yorkers under age 65 did not have coverage.
• It is estimated that 1.1 million New Yorkers will get health coverage in the marketplace.
• People with pre-existing conditions will have access to care if they choose to buy coverage through NY State of Health.¹

As you may know, beginning January 1, 2014, most Americans must have health insurance. The ACA requires you to get health coverage if you can afford it, or pay a penalty. The penalty is 1 percent of an individual’s income or $95 per person per year, whichever is more. This penalty is set to increase each year. However, there are circumstances where people may not have to pay a penalty for not having health insurance. A complete list of exemptions can be found at nystateofhealth.ny.gov/exemptions.html.

1. healthbenefitexchange.ny.gov/fast-facts