The New Yorkers' Guide To Obamacare



ny-2Photo: Courtesy of BarackObama.com.
As you've probably heard, the government has shut down. And though it's easy to imagine that at a time like this (and with weather like this), all the politicians are just sitting around Capitol Hill day drinking, there is one cog of the governmental machine that's still functioning today. Obama meant business when he said affordable health care was coming, whether the House Republicans liked it or not: As promised, you can apply for Obamacare right now. Since the nature of plans and pricing will vary from state to state, here's your guide to navigating Obamacare as a New Yorker.

What is it, and why do I need to check it out?
Before diving into the meat of the program, you should know that Obamacare in New York is actually called New York State of Health, and it's the answer to new legislation requiring most people to have medical insurance beginning January 2014. If you don't secure any insurance come 2014, you'll have to pay a penalty to the IRS when you file your taxes. Of course, there are exceptions to this rule, but in all likelihood, you'll need to set yourself up with some health insurance.

Who's eligible?
For NY State of Health, you must live in New York, be a U.S. citizen, national, or legal immigrant, and cannot be currently incarcerated.

How does it work?
NY State of Health functions like a marketplace, in that you can shop around for the plan that best suits your income and needs — even if the best plan ends up being the one your employer currently offers. In fact, these plans are really only financially better options if you're paying more than 9.5% of your salary for your employer's insurance plan. While pricing and plan eligibility entirely depends on factors specific to the applicant — like salary and existing medical coverage — a single person who makes less than or equal to $58,476 is eligible for Medicaid under NY State of Health. Though the specifics of your Medicaid will depend on your own financial situation and medical needs, you're looking at free or low-cost prescriptions (including birth control!), and the most you'll shell out for co-pays over 12 months is $200. Plus, any money you'll have to put towards co-pays won't be collected until April 2014, so even if you did end up having to pay $100 out of pocket for a medical service, you'll have some time to get the money together.

How do I apply?
Though the enrollment site is officially up and running, it received two million visits in the first two hours of its launch this morning, so accessing the actual sign-up page is proving a bit difficult. Once you get through (it took us four tries), make sure you have all the information you need, including social security number (or document numbers for legal immigrants), birth dates, employer and income information for everyone in your family, policy numbers for any current health insurance, and info about any job-related health insurance available to your family.

Can someone help me do this?
Absolutely. If you don't feel comfortable handling your own application online, there are four other options:

In-Person Assistors/Navigators: Real people who are fully trained in the know-how of NY State of Health. Their help is totally free, and you can find one in a convenient, community-based location. Look up yours here.

Certified Application Counselor (CAC): They're also trained to help you enroll, and some of them work in the healthcare field, like hospitals, clinics, or providers. You can call them Monday through Friday, 8 a.m. to 8 p.m., and even on Saturdays from 9 a.m. to 1 p.m. They were very helpful when we called with questions!

Brokers: A broker is a licensed professional certified by the marketplace to help you. Visit the NY State of Health site to find a broker.

Authorized Representative: This can be a trusted friend, relative, partner, or even a lawyer that can act on your behalf when enrolling for a plan. Authorize your representative here.

And remember: You can enroll today, but coverage doesn't begin until January 1, 2014. Until then, maybe look both ways before crossing the street, and don't eat any questionable-looking sandwiches.