Enrolling in a Private Plan

The following information is provided by Class Council.

What are these plans?

All private plans on the exchange are required by law to cover 10 essential benefits and have a government determined maximum annual out-of-pocket limits.  Although all plans on the exchange cover the exact same services, the point at which the plan “kicks in” and starts paying for them varies. The “Catastrophic Tier” plan is the bare minimum, providing no coverage of any costs until reaching a high deductible. Other metal tiers begin covering services at lower deductibles, lower copayments, at the cost of higher monthly premiums.

Healthfirst Green Leaf is a catastrophic plan accepted by most doctors at Mount Sinai (note: this is based on information reported by students; this plan is not officially endorsed by ISMMS.)

When can I enroll in them?

You may only enroll in a private plan on the NY Health Insurance Exchange during the national open enrollment period. The 2019 Open Enrollment Period ended January 31, 2019. However, there are many special circumstances under which you may enroll outside of the enrollment period (life changes such as job, residence, or insurance status change – e.g., your current insurance premium is no longer affordable). See if you’re eligible for a special enrollment period to sign up on the exchange outside of the aforementioned time window.

How do I enroll?

  • Since registering on the exchange website will automatically sign you up for Medicaid if you meet the eligibility criteria, you should contact the insurance company directly if you qualify for Medicaid but are opting instead for a private plan.
  • You may, however, use the “Preview” feature on NY’s Health Exchange to find a plan that suits you by starting here, typing your ZIP code, and on the next page, pick “Metal Level: Catastrophic.”
  • Once you’ve picked a suitable plan, click on the plan and click on “Plan Documents” to go to the insurance company’s website for more details on how to enroll.
  • When contacting the company, be sure to request a “Special Enrollment” in enrolling outside of the open-enrollment period (i.e., you just turned 26, or your school plan is ending and is unaffordable, etc.) and ask for the “Catastrophic Tier” plan.

Note that the information on this page is contributed by students in the interest of helping other students find a plan that best suits their individual needs; none of these options can be officially endorsed by ISMMS.

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