Jessica Anderson

As NY State of Health Extends Enrollment Deadline, Fidelis Care Offers Tips for Selecting Coverage

By a News Reporter-Staff News Editor at Managed Care Weekly Digest -- If you need health insurance coverage on January 1, 2015 and have yet to enroll through NY State of Health: The Official Health Plan Marketplace, time is running out. This Saturday, December 20, is the deadline to enroll for coverage that takes effect when the new year begins (see also Medical, Healthcare).

Choosing coverage is an important decision, but it doesn't have to be overwhelming. Fidelis Care Chief Marketing Officer Pamela Hassen offers the following tips to help you pick the coverage that's right for you.

Compare the coverage options:

The NY State of Health products are organized by metal level (platinum, gold, silver, and bronze), all offering the same coverage but with different monthly premiums and cost sharing. Hassen recommends taking a look at your health care needs to determine which metal level will be the most economical, balancing the premium with your expected out-of-pocket costs. While there are child-only products, you likely have the option of enrolling your child in quality, affordable coverage through the State-sponsored Child Health Plus program.

Determine the cost of coverage:

"Everyone wants to know how much their coverage will cost, but it's not always as simple as looking at the premium rate that's listed. Many individuals and families qualify for subsidies or tax credits that can lower their premiums and cost sharing," Hassen explained.

It's easy to get an estimate of your costs in about 60 seconds, using the Fidelis Affordable Care Advisor. Found on the homepage of Fidelis Care's website, fideliscare.org, the Affordable Care Advisor only needs basic information to calculate an estimated monthly premium, including federal subsidies and tax credits. It will also let you know if you may qualify for Medicaid.

Check the providers and the formulary:

If you prefer to see specific doctors or regularly take certain prescription drugs, be sure to do your homework. Hassen advises you check the health plan's provider network to see if your specific doctor is included. Also, drug formularies vary from health plan to health plan. It's important to consider how much you will pay for specific prescription drugs.

Keep an eye on the calendar:

While you must enroll by December 20 in order for your coverage to be effective on January 1, 2015, NY State of Health open enrollment runs through February 15, 2015. After that time, it is difficult to select or change health insurance coverage. Most New York State residents are required to have health insurance coverage in 2015 or face a tax penalty.

To make the enrollment process as easy as possible, Hassen recommends turning to an expert for assistance.

"Our trained representatives will meet you at our office, a community location, or even at your home. They are experts and can make sure you enroll correctly and sign up for federal assistance if you are eligible," she said.

To prevent and detect fraud within the health care and the insurance industry, Harver Health Insurance Counter Fraud Group will help you. The Harver Health Insurance Counter Fraud Group has official connections with health fraud investigation agencies.