Short-term health plans in New York
New York’s short-term health insurance regulations
All individual and group health insurance plans in New York must be guaranteed renewable (with limited exceptions, such as nonpayment of premiums, fraud, or an insurer’s discontinuation of all policies in a given market). As such, plans with limited terms are not permitted.
In addition, New York requires that “every accident and health insurance policy or contract that provides hospital, surgical or medical expense coverage must be comprehensive and, with respect to individual and small group coverage, must provide coverage for essential health benefits.” Short-term plans in most states typically don’t cover some of the essential health benefits (maternity, mental health/substance abuse, and prescription drug coverage are often not included), and such plans could not be sold in New York.
As a result of those two regulations, short-term health insurance plans in New York can not be sold. The Trump Administration’s new rules for short-term plans are clear in noting that states may continue to impose tighter regulations than the new federal rules, and New York clarified that they will continue to prohibit the sale of short-term health insurance in New York .
Who can get short-term health insurance in New York, and when should I consider it?
Under long-standing rules, New York does not allow the sale of short-term health insurance plans, so no one is able to purchase a short-term health plan anywhere in New York state.
There are a variety of qualifying life events that will trigger a special enrollment period allowing you to buy a plan through the health insurance marketplace in New York. These plans are purchased on a month-to-month basis, so you can enroll in a plan even if you only need coverage for a few months before another policy takes effect (with a premium subsidy if you’re eligible).
Based on your income you may also qualify for health insurance in New York under expanded Medicaid coverage. When the Affordable Care Act was enacted in 2010, Medicaid expansion was a cornerstone of lawmakers’ efforts to expand realistic access to healthcare to as many people as possible. If you have a household income up to 133 percent of poverty (138 percent with the 5 percent income disregard) would be able to enroll in Medicaid.
Louise Norris is an individual health insurance broker who has been writing about health insurance and health reform since 2006. She has written dozens of opinions and educational pieces about the Affordable Care Act for healthinsurance.org. Her state health exchange updates are regularly cited by media who cover health reform and by other health insurance experts.