The state attorney general is advising New Yorkers to compare and evaluate health insurance plans -- even if you already have one -- as open enrollment is set to begin Sunday on the state's exchange.
"Take the time during open enrollment to compare plans, on and off the marketplace, and evaluate which plans will work best for you based on your own unique medical needs -- including the likelihood of needing significant medical care or using particular medications," Attorney General Eric T. Schneiderman said in a news release. "Remember that not all health plans cover all medications, and you may pay more out-of-pocket, or face more barriers to coverage, under some plans compared to others."
The attorney general is releasing a brochure titled "Shopping For Health Insurance Coverage" Friday that can be used to evaluate health plans on and off the exchange. It will be distributed through the attorney general's regional offices, on the website ag.ny.gov, and via social media.
The attorney general also advises people to:
Find out if you are eligible for a premium subsidy through the marketplace to make coverage more affordable. Subsidies are only available through the exchange.
Check what the deductible is as well as what the co-payment or coinsurance will be for any medical services you expect during the plan year.
Make sure your doctors and hospitals are in the plan.
Check whether your prescription medications are included in the health plan's formulary, as well as what your out-of-pocket expense will be and whether there are any pre-authorization requirements.
Schneiderman also recommends calling the insurance company directly if you have any questions about a health plan's coverage, such as whether your doctors or hospitals are participating. Take detailed notes, including when you called, with whom you spoke, what you discussed and what you were advised, he said.
If you encounter inaccurate provider listings once enrolled in a plan and cannot get care from that provider, or believe you were given inaccurate information, contact the attorney general's Health Care Bureau Helpline: 800-428-9071.
HOW TO SIGN UP: HEALTH INSURANCE ENROLLMENT
Nov. 1: Open enrollment starts.
Dec. 15: Last day to enroll in or change plans for new coverage to start Jan. 1, 2016.
Jan. 1: 2016 coverage starts for those who enroll or change plans by Dec. 15.
Jan. 15: Last day to enroll in or change plans for new coverage to start Feb. 1.
Jan. 31: Open enrollment ends. Enrollments or changes between Jan. 16-Jan. 31 take effect March 1.
To get help
In person: The Nassau-Suffolk Hospital Council provides free in-person navigators at various sites throughout Long Island. These sites are offered on a first-come, first-served basis with no appointments. Go to the website for a calendar of dates, times and places, nshc.org, or call 631-435-3000.
By appointment: Contact one of these navigator agencies.
Community Service Society of New York: 888-614-5400
Public Health Solutions: 646-632-5986
By phone: New York State of Health customer service line, 855-355-5777
Online: New York State of Health website, www.nystateofhealth.ny.gov
Customer service numbers/websites of health insurance companies: http://info.nystateofhealth.ny.gov/resource/health-plan-customer-service-phone-numbers-and-provider-networks
Suggested documentation to have available when applying:
Social Security numbers
Document numbers for legal immigrants. If you are a naturalized citizen you will need to have your alien identification number and your certificate number to complete the application.
Pay stubs, W-2 forms, or other information about your income
Policy/member numbers for any current health coverage
Information about any health coverage from a job available to you or your family
Sources: Nassau-Suffolk Hospital Council; New York State of Health; healthcare.gov