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New York State Health Insurance

Many people may not be aware of this Health Insurance concern. With the deadline fast approaching to sign up for Healthy New York’s ‘Individual Health Insurance’ through the exchange, you might be unaware that New York State has dropped out of network benefits. This affects almost all Health Insurance Plans, not just those on the exchange. What does this change really mean to you? Well, here’s some extra information to help clarify things.

According to Medical News Today, Health Insurance is “a type of insurance coverage that covers the cost of an insured individual’s medical and surgical expenses. Depending on the type of health insurance coverage, either the insured pays costs out-of-pocket and is then reimbursed, or the insurer makes payments directly to the provider.” In New York State, this is changing. As of December 31st, any plans renewed after that date will not include out of network benefits. In the past when you saw a doctor who did not accept your insurance, chances are you would submit a bill to the insurance company. The insurance company would then reimburse you a portion of what you paid. Unfortunately, this is not happening anymore!

New York State is no longer requiring health insurance plans to offer an out-of-network benefit, and so the insurance plans are dropping them. Let me repeat that: MOST INSURANCE PLANS WILL NOT BE OFFERING AN OUT OF NETWORK BENEFIT!!!! That means you will no longer be reimbursed for your doctors who are not in the network, and who do not accept your health insurance. Please note, that these same insurance companies dropped many doctors who were on the insurance plans simply because they believed that having a smaller network meant they could keep their costs down. They are also paying those particular doctors less.

When New York State was given the option of having out of network benefits, they placed the decision in the hands of the insurance companies. Those companies decided that it was too expensive to cover out of network benefits, and they dropped them. So, if you get your insurance on New York’s Health Exchange, chances are you will not have out of network benefits. If you get your insurance through work, you may not have out of network benefits, either.

Not happy? Call your local senator or congressman and let them know that you want to continue receiving out of network benefits. If insurance companies paid their in network doctors appropriately, most would be pleased to continue being in network. Here’s the thing, you deserve to see a doctor of your choosing without making a choice between your health and your wallet.

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