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New York

New York Health Insurance

New York has has more health insurance regulations than most states. It's important to familiarize yourself with them so you are more confident, more knowledgeable, and wiser in your purchase.

This guide:

  • Describes New York health insurance policy regulations.

  • Lists rules New York health insurance companies must follow.

Health insurance policies are regulated by each state's own health insurance laws. New York health insurance companies and policyholders alike must abide by established insurance laws.


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Do You Qualify For A Subsidy?


Find out if you qualify for a government subsidy under Obamacare. Millions of Americans will have their insurance rates reduced under the new health care law. Learn how much you could save with our simple calculator.

New York health insurance policy provisions

Some of the most important New York health insurance laws are the ones that specifically influence the health insurance policy. First, New York requires that your policy contain a provision called the "guaranteed renewability" clause. This clause ensures that, at the end of your New York health insurance policy's term, you always have the option to renew your policy for another term.

Another provision to be aware of concerns "pre-existing conditions," or medical conditions you suffer from or have suffered from or been diagnosed with before the effective beginning of the policy. By law, New York health insurance policies can only include a pre-existing condition exclusion period up to a maximum of 12 months.

Medical conditions are considered to be pre-existing if you received medical treatment for or were diagnosed with them 6 months prior to the beginning of the plan. If you are switching New York health insurance and have had no breaks in your coverage, your old coverage can be used to credit the pre-existing condition period of your new plan.

New York health insurance policies can not contain elimination riders, which eliminate coverage for certain conditions permanently.

There are also two New York health insurance policy provisions that concern dependents. In New York, parents' individual health insurance policies that cover dependents also automatically cover newborns and adopted children for at least 30 days after birth or adoption. Also, dependents with handicaps that are over the legal age limit may still be covered under a parent's individual New York health insurance plan.

Regulating New York health insurance companies

New York health insurance companies that sell individual health insurance cannot refuse to sell you insurance and must provide family coverage, if desired.

New York health insurance laws state that you cannot be denied health insurance due to your health status, age, or any other factor. Also, the cost of your New York health insurance premiums cannot be dependent upon your health, occupation, age, or gender.

In New York, HMOs must offer a standardized New York health insurance policy that offers comprehensive coverage. Although your health insurance policy can be canceled for some certain reasons, New York health insurance laws prohibit health insurance companies from terminating your policy on the grounds of illness.

Temporary New York health insurance

Temporary New York health insurance is a wise purchase to make when you have breaks in between your health insurance coverage. The best option for temporary health insurance in New York is to buy a conversion policy.

Applications for a conversion policy must be received no later than 45 days after the end of your previous New York health insurance policy.

You are eligible for a conversion policy if you have left a fully insured group policy or if you have used up your COBRA continuation coverage. You can also qualify for a conversion policy if you lost your New York health insurance because you formerly were covered under your parent's New York health insurance policy.

More NY health insurance help

If you want more help getting the a good health insurance policy, read our guide to health insurance.

Also see the guide to New York small business health insurance.


To find out more about NY health insurance laws and regulations, visit the official website of the New York Insurance Department.





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This internet site provides information of a general nature for educational purposes only and is not intended to be legal advice. We make no guarantees as to the validity of the information presented. Your particular facts and circumstances, and changes in the law, must be considered when applying insurance law. You should always consult with a competent insurance professional licensed in your state with respect to your particular situation.