Availability of short-term health insurance in New York

No. The sale of short-term health insurance plans has been prohibited by New York’s government.

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 healthcare plans in most states typically don’t provide coverage for 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 rules for short-term plans, which took effect in 2018, are clear in noting that states may continue to impose tighter regulations than the new federal rules, and New York clarified that they would continue to prohibit the sale of short-term health insurance in New York.

Need health insurance and not eligible to enroll in an employer’s plan? We advise you to check to see if you can enroll in an ACA-compliant major medical plan (Obamacare), either through the New York health insurance exchange/marketplace or directly through a health insurance company.

Open enrollment for these plans lasts longer in New York than in most states, as New York has consistently opted to extend open enrollment through the end of January (open enrollment also starts a little later in New York, on November 16 instead of November 1).

If you’re trying to enroll outside of the open enrollment period, you’ll need a qualifying life event in order to trigger a special enrollment period. A wide range of events will grant you a special enrollment period, including pregnancy (this is a New York rule; pregnancy is not a qualifying event in most states).

ACA-compliant major medical policies 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. So for example, if you’ll soon be covered by an employer’s plan or Medicare, you can still sign up for an ACA-compliant plan during open enrollment or a special enrollment period, and then cancel it when your Medicare or employer-sponsored policy starts to provide coverage.

Depending on your income, you may qualify for a premium subsidy if you enroll in a plan through New York’s marketplace. And New York also has The Essential Plan, which offers low-cost health coverage to people with income up to 200% of the poverty level. The state is working to expand this to include people up to 250% of the poverty level starting in 2024.

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. New York implemented these eligibility rules in 2014, so if you’re an adult under age 65 and have a household income up to 138% of the poverty level, you can enroll in Medicaid in New York.

In New York, CHIP eligibility for kids extends up to households earning 400% of the poverty level (by far the highest in the United States), which is $120,000 for a family of four in 2023. So most families with modest and middle-class incomes are eligible for CHIP coverage for their children in New York, with low out-of-pocket costs.

New York also has a Basic Health Program, known as the Essential Plan, which is available with zero premiums for people whose income doesn’t exceed 200% of the poverty level. The state is working to expand the eligibility limit to 250% of the poverty level as of 2024, albeit with a modest $15/month premium for enrollees above 200% of the poverty level.

Consumers in New York can buy ACA-compliant health insurance through the state’s marketplace, New York State of Health.  Twelve carriers offer coverage through the exchange in 2023.

ACA-compliant plans are purchased on a monthly basis, so you can enroll in coverage even for only a few months until another policy takes effect — and if you’re eligible, you may qualify for financial assistance in the form of a premium subsidy.

New York residents may also be eligible for Medicaid coverage.