New Yorkers can purchase affordable health insurance through the state marketplace.
The average cost of health insurance in New York is $701, which is about 1% more expensive than it was in 2020.
To help you find the best coverage, we analyzed Silver health insurance policies available across all counties and found that the Fidelis Care, Silver, was the cheapest plan available.
However, there are many insurers offering health plans in New York, and where you live will determine available companies and policies.
- Cheapest health insurance by metal tier
- Overview of New York individual health insurance plans
- Health insurance rate changes in New York
- Short-term health insurance in New York
- Greater New York health insurance companies
- Average cost of health insurance by family size
or through Medicaid if their household income falls below 138% of the federal poverty level.
Cheapest health insurance by metal tier
To help you to compare prices and choose the best policy, we identified the most affordable health insurance plans available in the state of New York. Health insurance is offered at five different tier levels in New York: Catastrophic, Bronze, Silver, Gold and Platinum.
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As you can see above, when the tier level increases, the monthly premium becomes more expensive. Similarly, as the tier level increases, the deductible and out-of-pocket maximum decrease.
Additionally, the price will vary according to the number of people covered. When you add either an adult or dependents to a policy, the monthly premium increases. The plans shown below may not be available in your county but can help you compare costs in that tier.
Metal tier Plan marketing name Deductible Maximum cost Monthly premium
Catastrophic Fidelis Care Catastrophic ST INN Pediatric Dental 3 Free PCP Visits Free Telemedicine $8,150 $0 $143
Bronze Fidelis Care, Bronze, ST, INN, Fidelis Care HBX Network, Pediatric Dental, Dep25, Free Telemedicine $8,550 $4,700 $336
Silver Fidelis Care, Silver, ST, INN, Fidelis Care HBX Network, Pediatric Dental, Dep25, Free Telemedicine $8,500 $1,300 $473
Gold Fidelis Care, Gold, ST, INN, Fidelis Care HBX Network, Pediatric Dental, Dep25, Free Telemedicine $4,000 $800 $570
Platinum Fidelis Care, Platinum, ST, INN, Fidelis Care HBX Network, Pediatric Dental, Dep25, Free Telemedicine $2,000 $0 $691
Finding the best health insurance coverage in New York
The best health insurance policy for your family will depend on the availability of plans in your area, as well as your medical and financial situation. When deciding on the right type of plan, you should determine affordability by reviewing the premiums and deductibles for each metal tier. Generally, if you have an emergency savings account and don’t expect to have significant health or medical expenses, then a lower metal tier plan with more affordable premiums would make more financial sense.
Gold and Platinum plans: Best if you expect high medical costs
Gold and Platinum plans are the highest tier health insurance policies available in New York. These plans often have the most expensive monthly premiums but come with lower deductibles and out-of-pocket maximums.
For example, if you frequently use expensive prescription drugs, an upper-tier health plan could be the right choice.
Silver plans: Best for people with low income or average medical costs
Silver plans are middle-ground policies that fall between Gold and Bronze plans with regard to premiums and out-of-pocket expenses. We would recommend a Silver plan in most situations — but if you are very healthy, Bronze may be best in terms of cost-effectiveness.
On the other hand, if you expect a lot of medical expenses, then a Gold plan may better fit your needs.
Silver plans are eligible for cost-sharing reduction (CSR) subsidies in New York if your income falls below 250% of the federal poverty level. If this applies to you, then you can receive discounts on deductibles, coinsurance and copayments.
Bronze and Catastrophic plans: Best for young, healthy individuals
Bronze and Catastrophic tiers have the lowest premiums available on the New York marketplace but also the highest deductibles and cost-sharing. These metal tier plans should only be considered if you have good health and do not expect to have high medical costs.
Bronze plans are available to all consumers, but Catastrophic policies have eligibility requirements. These plans are only available to people under 30 years old or those with a hardship exemption.
New York individual health insurance plans overview
You can purchase health insurance in New York through the NY State of Health marketplace. Health insurance in New York is one of the most heavily regulated in the United States. While the federal Affordable Care Act limits how insurers can price their policies, New York’s regulations are even more restrictive.
For example, most other states allow insurers to charge older people and smokers a higher health insurance premium. But in New York, insurers are prohibited from using any personal information for calculating premiums, using only where you live as a factor.
For both individual plans and small-business plans, all consumers living in a specific location pay the same price for health insurance. This means younger New York residents pay more for health coverage than they would in other states, while older residents pay less than they would in other states.
Open enrollment in New York begins Nov. 1 and continues through Jan. 31.
If you are a first-time buyer, then you can purchase a health insurance plan once enrollment opens, while people who are renewing a plan can do so beginning Nov. 16. If you buy a health plan before Dec. 15, then your effective coverage will begin Jan. 1. New York’s exchange portal also lists brokers who can provide guidance and help you enroll in a health plan.
Health insurance rate changes in New York by metal tier
Health insurance rates are determined by each insurer and are submitted for approval to the New York state exchange. For 2021, the largest rate increase occurred in Platinum plans, which rose in price by an average of $34 per month or 3.34% from the previous year.
Metal tier 2019 premium 2020 premium 2021 premium Change
Catastrophic $273 $278 $287 3.09%
Bronze $468 $500 $514 2.78%
Silver $651 $683 $701 2.68%
Gold $777 $826 $842 1.98%
Platinum $978 $1,030 $1,064 3.34%
Short-term health insurance in New York
Short-term health insurance plans are prohibited in New York because all health plans must be renewable and cover the minimum essential benefits.
Most short-term plans typically do not cover the essential benefits (maternity, mental health, prescription drugs usually are not covered) and thus are not offered on the New York state health insurance marketplace.
Age 29 rider coverage expansion
Under the Affordable Care Act, young adults can be covered under their parents’ health insurance plans up to the age of 27. Because of the way insurance is priced in New York, it is preferable for young adults to stay on their parents’ plans until the legal age limit, since the additional cost is at most 70%–85% of the parents’ health plan premium.
For example, say your young adult child has passed the age of 27 but does not have a job or sustainable income to pay for their own insurance. In this case, you could pay a small extra premium along with your normal health insurance rate that would allow your coverage to support your son or daughter. To qualify, the young adult must:
Be unmarried.
Be 29 or younger.
Not be insured or eligible for insurance through their employer.
Live, work or reside in New York state or the insurance carrier’s coverage area.
New York health insurance companies
There are currently 18 insurers that sell individual plans on the New York health insurance marketplace:
MVP Health Care
Fidelis Care
CDPHP
HealthPlus
BlueShield of Northeastern New York
EmblemHealth
Empire Blue Cross Blue Shield
Univera Healthcare
Independent Health
BlueCross BlueShield of Western New York
MetroPlus Health Plan
Healthplus
Oscar
Health First
United Healthcare
Empire Blue Cross
Univera HealthCare
Excellus
Some of these insurers may not be available depending on where you live. The availability of insurers and health plans changes by county, so your location will directly impact your coverage options.
Medicaid health insurance coverage in New York
New York’s Medicaid program is a form of health insurance for those who can’t pay for an individual plan. Qualifying for Medicaid is primarily a function of your income and household size. Through the state’s expansion of Medicaid, most households with modified adjusted gross incomes (MAGI) under 138% of the federal poverty level (FPL) are eligible for Medicaid coverage in New York.
The income limits for children and pregnant women are slightly higher than those for adults. Children up to the age of 19 are eligible for a special type of Medicaid if the household income is under 154% of the FPL, while pregnant women and infants up to the age of 1 are eligible if the household earns less than 223% of the FPL.
The following table illustrates the maximum yearly income a family can have in order to qualify for the Medicaid thresholds in New York.
Family size Maximum income level per year
1 $16,971
2 $22,930
3 $28,888
4 $34,846
5 $40,805
6 $46,763
7 $52,722
8 $58,680
How does Medicaid coverage work?
If you apply for Medicaid in New York, you will be asked to select a health plan managed by an insurance carrier, such as UnitedHealthcare or Empire BlueCross BlueShield. These insurance companies also sell individual health insurance policies and small-business coverage, and the plans themselves operate similarly.
Each Medicaid plan will come with a network of doctors and health care providers that accept the insurance.
However, health plans offered as part of the Medicaid program may have a different network of doctors when compared to other plans offered by the same insurance carrier. If you have a physician you prefer, it’s important to make sure they are covered in the new network.
Average cost of health insurance by family size
Along with your county of residence, the number of people covered under the health plan will affect the premiums you pay. Below, we have provided the average cost of a Silver health plan for a variety of family sizes. Note that, for a family, the average cost for a Silver policy is $1,894 no matter how many dependents are covered under the health insurance plan.
Family size Average monthly cost of health plan
Premium adult individual $701
Premium adult and child $1,193
Premium couple $1,403
Premium family $1,894
Child Health Plus coverage for children
In New York, Child Health Plus is a health insurance program for children in households that have incomes too high to qualify for Medicaid but are less than 400% of the federal poverty level. Like Medicaid, Child Health Plus plans are managed by the same insurance carriers on the individual and small-business market.
Families with children under the age of 19 who qualify for Child Health Plus pay significantly lower health insurance rates for covering the child. The amount a family contributes is based on the family size and household income, with premiums per child ranging from $9 to $60 per month.
For families with multiple children, the maximum contribution is three times the per-child premium. For example, if you fall into the $9-per-child threshold group, then the maximum you would pay for all your children would be $27, even if you purchase coverage for more than three children.
Maximum monthly income to be eligible for Child Health Plus: By number of children
Cost per month 1 2 3 4 5 6 7 8 Each additional person
Free insurance $1,701 $2,298 $2,895 $3,493 $4,090 $4,687 $5,285 $5,882 $598
$9 $2,361 $3,190 $4,019 $4,847 $5,676 $6,505 $7,334 $8,163 $829
$15 $2,659 $3,592 $4,525 $5,459 $6,392 $7,325 $8,259 $9,192 $934
$30 $3,190 $4,310 $5,430 $6,550 $7,670 $8,790 $9,910 $11,030 $1,120
$45 $3,722 $5,029 $6,335 $7,642 $8,949 $10,255 $11,562 $12,869 $1,307
$60 $4,254 $5,747 $7,240 $8,734 $10,227 $11,720 $13,214 $14,707 $1,494
Recap of the best cheap health insurance in New York
Catastrophic: Fidelis Care Catastrophic ST INN Pediatric Dental 3 Free PCP Visits Free Telemedicine
Bronze: Fidelis Care, Bronze, ST, INN, Fidelis Care HBX Network, Pediatric Dental, Dep25, Free Telemedicine
Silver: Fidelis Care, Silver, ST, INN, Fidelis Care HBX Network, Pediatric Dental, Dep25, Free Telemedicine
Gold: Fidelis Care, Gold, ST, INN, Fidelis Care HBX Network, Pediatric Dental, Dep25, Free Telemedicine
Platinum: Fidelis Care, Platinum, ST, INN, Fidelis Care HBX Network, Pediatric Dental, Dep25, Free Telemedicine
Methodology
ValuePenguin collected rates from New York’s state health insurance exchange. We gathered rates and plan details from every county in the state, then we averaged the rates and sorted them by metal tier, age and family size. This allowed us to compare rates and find the cheapest providers in New York.