Compare Plans

We offer a range of plans through New York’s health insurance marketplace as well as other coverage options for individuals and families.

Financial assistance: You may be eligible for tax credits to help with premiums and out-of-pocket costs when enrolling through NY State of Health (NYSOH).

Bronze

Silver

Gold

Platinum

A smart choice if you want to pay less for premiums and don’t seek frequent medical care.

Monthly Premium:

In-Network Deductible:
High

See Details Hide Details

A good balance if you go to the doctor regularly but want a low premium.

Monthly Premium:

In-Network Deductible:
Moderate

See Details Hide Details

Consider this if you go to the doctor often and want a low deductible.

Monthly Premium:

In-Network Deductible:
Low

See Details Hide Details

An option if you receive frequent care and don’t want a deductible.

Monthly Premium:

In-Network Deductible:
Lowest

See Details Hide Details

Highlight Differences
Monthly Premium
LowestLowModerateHigh
Deductible
$4,125 individual/$8,250 family$2,450 individual/$4,900 family$775 individual/$1,550 family$0 individual/$0 family
Maximum Out-of-Pocket
$10,150 individual/$20,300 family$10,150 individual/$20,300 family$10,150 individual/$20,300 family$2,000 individual/$4,000 family
Summary of Benefits and Coverage
Marketplace Plans*
Off-Exchange Plans Marketplace Plans*
Off-Exchange Plans Marketplace Plans*
Off-Exchange Plans Marketplace Plans*
Off-Exchange Plans
Network
9 counties9 counties9 counties9 counties
Referrals
Required for specialist visitsRequired for specialist visitsRequired for specialist visitsRequired for specialist visits
Out-of-Network Coverage
No coverage for nonemergency servicesNo coverage for nonemergency servicesNo coverage for nonemergency servicesNo coverage for nonemergency services
Preventive Care
Covered in full**Covered in full**Covered in full**Covered in full**
Primary Care Provider (PCP) Visits
$50 copay after deductible with up to three copay visits*** before deductible$30 copay after deductible with one copay visit*** before deductible$25 copay after deductible$15 copay
Specialist Visits
$75 copay after deductible with up to three copay visits*** before deductible$65 copay after deductible with one copay visit*** before deductible$40 copay after deductible$35 copay
Telemedicine
Covered in fullCovered in fullCovered in fullCovered in full
Urgent Care
$75 copay after deductible$70 copay after deductible$60 copay after deductible$55 copay
Emergency Room
$500 copay after deductible$500 copay after deductible$150 copay after deductible$100 copay
Pharmacy
$10 copay for generic drugs after deductible$15 copay for generic drugs before deductible$10 copay for generic drugs before deductible$10 copay for generic drugs
Gym Reimbursement
Reimbursement up to $400 per calendar year if qualifiedReimbursement up to $400 per calendar year if qualifiedReimbursement up to $400 per calendar year if qualifiedReimbursement up to $400 per calendar year if qualified
Pediatric Dental and Vision
Coverage up to age 19Coverage up to age 19Coverage up to age 19Coverage up to age 19
Health Savings Account (H.S.A) Compatible
YesNoNoNo

*Plans through NY State of Health (NYSOH).

**Preventive services are not subject to cost-sharing (copayments, deductibles, or coinsurance) when performed by a network provider and provided in accordance with the comprehensive guidelines supported by the Health Resources and Services Administration (HRSA), or if the items or services have an “A” or “B” rating from the U.S. Preventive Services Task Force (USPSTF), or if the immunizations are recommended by the Advisory Committee on Immunization Practices (ACIP), or when required by state law.

***Predeductible visit(s) apply to any combination of PCP, specialist, allergy testing and treatment, chiropractic services, second opinions, applied behavioral analysis (ABA) treatment, or outpatient mental health/substance use disorder.