Q. What is the New York State of Health – Insurance Exchange?

A. The New York State of Health Insurance Exchange offers affordable, comprehensive healthcare coverage to all eligible residents in New York. Here consumers can compare the costs and benefits offered by the various participating Qualified Health Plans in their region of the state. This on-line health care exchange serves to help lower the cost of health care coverage and makes it accessible to those people who either never had coverage or who feel that the coverage they have is not adequate for their needs.

Q. Who is eligible?

A. There are 2.7 million New Yorkers with little or no health care coverage. Many people who are uninsured are people who are employed but their jobs do not include health benefits. There are also many individuals and families who are uninsured because they earn too much money to qualify for government funded programs. The New York State of Health – Insurance Exchage was created to help these people. It is estimated that over 1 million New Yorkers will be able to get coverage through the New York State of Health Insurance Exchange. If an individual earns less than $45,960 or if a family of four has a household income of less than $94,200 they may be eligible for a subsidized plan. Applicants may also be eligible for advance premium tax credits if they earn between 100%-400% the Federal Poverty Level.

Q What is included in the planned coverage?

A All of the health plans provide coverage in the following areas: ambulatory patient services, emergency services, hospitalization, maternity and newborn care, mental health and substance use disorder services, prescription medications, rehabilitative and habilitative services and devices, laboratory services, preventative and wellness services and chronic disease management, pediatric services including oral and vision care. Some health plans will offer additional benefits that include adult vision and dental coverage at an additional fee.

Q Do I have the freedom to choose a specific Qualified Health Plan from the New York State of Health – Insurance Exchange?

A. Yes. You can choose from many participating Qualified Health Plans by going to

• www.newyorkstateofhealth.ny.gov

Q. What Qualified Health Plans does Jamaica Hospital Medical Center accept through the New York State of Health – Insurance Exchange?

A.

The Qualified Health Plans accepted by Jamaica Hospital Medical Center as of January 2014 are:

• HealthFirst
• Emblem
• Empire Blue Cross
• United Healthcare
• Oscar
• Freelancers (Health Republic)
• Fidelis
• Affinity

If you currently receive health services at Jamaica Hospital Medical Center, or if
you would like to receive health care services with us once you enroll, you should enroll in one of the plans listed above. Some plans offer Certified Application Counselors who can assist you with your enrollment.

Q What should I consider before choosing a Qualified Health Plan?

A You can choose from a variety of Qualified Health Plans. Review all the facts about each plan and choose the one that is best suited for your individual or family needs. Compare each plan based on pricing, including all associated costs such as monthly fees and co-payments. Also review which providers (doctors and hospitals) are in the plan’s network as well as all quality indicators of those providers. Each plan’s quality ranking is included on the New York State of Health website.

Q How Do I enroll in the New York State of Health – Insurance Exchange?

A You can get information and enroll in a Qualified Health Plan either online at www.newyorkstateofhealth.ny.gov or by calling toll free 1-855-355-5777. There are over 500 Navigators who have been trained and are ready to provide high quality enrollment assistance. Assistance is available in a total of 48 languages. If you prefer to enroll in person, you can find a Navigator by county on the website. Some Qualified Health Plans also have Certified Applications Counselors (CAC) who can help with enrollment.

Q Is there a penalty if I do not enroll?

A People who do not enroll in a Qualified Health Plan may have to pay a tax penalty to the federal government. These penalties will increase annually. To learn more about penalties, please speak to a Navigator or CAC.

Q Can I buy insurance through the New York State of Health Insurance Exchange if I already have a serious health problem?

A A person is eligible to purchase a health plan even if they have been diagnosed with a serious medical condition. The cost of the plan will not be affected by your health status. A person cannot be charged more because of a pre-existing health condition. It also means you will not have to wait to get the coverage you need.

Q What is the timeline for enrollment and when does the health coverage begin?

A. The enrollment process began on October 1, 2013 and runs until March 31, 2014. In future years, enrollment will begin on October 15th and end on December 7th.After March 31st, only individuals who experience a “Life Changing Event” will be able to enroll in a Qualified Health Plan.

Q. How can Jamaica Hospital assist me with regard to the New York State of Health – Insurance Exchange?

A. Many of Jamaica Hospital’s employees have be trained and certified to help guide you through the process of enrolling in a Qualified Health Plan. We also have speakers who are available to attend community functions who can help to explain the details of the New York State of Health – Insurance Exchange.. Additionally, we have set up a dedicated phone line, 718-206-6649. This information is also available on our website in multiple languages.

Q. Can I still go to Jamaica Hospital in an Emergency if I do do have a Qualified Health Plan that is accepted?

A. Yes. New York State law states that everyone is eligible to receive emergency care, regardless of what health care coverage they have.

.

.