More Healthy NY Financial Eligibility Requirements and Changing HMO's
5. You must be uninsured for the 12 months prior to applying for Healthy NY or have lost coverage due to a specific event.
If you lost your health insurance coverage due to a specific event, you may still be eligible for Healthy NY if you meet all of the other eligibility requirements. Specific events include the following:
- Losing employment, changing to a new employer, leaving the workforce, or retiring
- Death of a family member
- Changing residence
- Discontinuing a group health plan
- Terminating or canceling COBRA coverage
- Legal separation, divorce, or annulment
- Losing eligibility for group health insurance coverage
- Reaching the maximum age for dependent coverage
Please note that being unable to afford current health insurance premiums is not a specific event.
If you are eligible for COBRA coverage or currently have COBRA or other continuation-type coverage, then you may apply for Healthy NY. You are not required to apply for COBRA coverage. If you are currently enrolled in COBRA coverage, you are not required to keep it. If you have had coverage through a public program such as Family Health Plus, Child Health Plus, or Medicaid, you may still apply for Healthy NY, even if it was within the last 12 months.
Changing HMOs
You may change HMOs at any time by submitting a new application to a new HMO. However, payments towards any deductibles will not carry over to the new HMO, and you will have to meet all of the Healthy NY eligibility requirements at the time of your new application.
Eligibility Recertification and Mid-Year Changes in Eligibility Requirements
Healthy NY understands that your household size, income, and other factors may change after you enroll in Healthy NY. Mid-year changes will not cause you to lose coverage immediately. Healthy NY has a yearly recertification process, at which time the HMO will review your eligibility.
Each year you must complete a recertification form that shows you are still eligible for Healthy NY. Your HMO will send you this form and will tell you when it is due. If you do not meet the eligibility requirements at the time of recertification, then you will be unable to continue to participate in the program. You do not have to be working when you recertify your eligibility.
Resources:
- » Claim Denials on the Grounds that a Treatment is Not a Covered Health Insurance Expense
- » Claim Denials on the Grounds that a Treatment is Not Medically Necessary
- » Problems Related to Health Insurance Coverage for Durable Medical Equipment
- » Claim Denials on the Grounds that the Treatment is Experimental
- » Summary of Traditional Individual and Group Plans, Doctors' Bills
Articles:
- » Introduction to Traditional Individual and Group Plans, Hospital Bills
- » Checking the Hospital Bill in Regards to a Health Insurance Claim
- » Problems Related to Health Insurance Coverage for Durable Medical Equipment
- » A Hypothetical Hospital Bill For Use in Health Insurance Claims
New York Health Guide Pages:
- » Introduction to Healthy NY Low-Cost Health Insurance
- » Healthy NY Health Insurance Coverage and Benefits
- » Services Not Covered and Co-Payments of the Healthy NY Health Insurance Plan
- » NY Health's High Deductible Health Plans and Health Savings Accounts
- » Health Savings Accounts for High Deductible Health Insurance Coverage
- » Healthy NY Health Insurance Program Eligibility
- » Health NY Health Insurance Program Income Guidelines
- » More Healthy NY Financial Eligibility Requirements and Changing HMO's
- » Healthy NY Health Insurance Information for Sole Proprietors
- » New York State Public Health Programs for Health Insurance Coverage
- » Selecting a New York Health Insurance Plan with Healthy NY
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