As health care costs rise, New Yorkers are doing what they can to maximize their coverage.
While Affordable Care Act plans are pricier due to Congress not extending the subsidies helping many people pay their premiums, states overall are seeing wide increases in health insurance costs. Research showed New York has the fourth-highest monthly insurance costs nationwide.
Diane Spicer, supervising attorney of Community Health Advocates for the Community Service Society of New York, said plans which are not Affordable Care Act compliant should be avoided.
“They don’t cover those essential health benefits, have very high up-front costs, or are different kinds of health care sharing services that are a pool of money that may or may not pay out claims,” Spicer cautioned. “Those private contractual agreements are not health insurance.”
Though the enrollment period is closed, she said people should maximize the policy’s coverage of preventive care services like blood tests and annual physicals to ensure they are healthier. As federal cuts and changes to Medicaid take hold soon, New York’s 2027 budget is accounting for the change with funding increases for such services and other health care resources.
Other than the cost, some people do not take the time to learn much about their workplace health insurance plans. Data show 25% of workers said they know little to nothing about their employer-sponsored benefits.
Leslie Moran, senior vice president of the New York Health Care Association, said with rising costs taking a hit on employers too, employers and employees need to have open conversations about what workplace health coverage looks like.
“Any changes that take place year to year, such as an increase in the employee’s percentage they put toward their health insurance, or an increase in the deductible that has to be met before the health insurance kicks in,” Moran outlined.
The health care system can be confusing to navigate. More digital resources are available to direct people and answer some questions.
Amy Jordan, vice president of consumer experience for UnitedHealthcare, said when choosing a health plan, the most important consideration is its benefits.
“What is covered, or what’s not covered, and what you can expect,” Jordan explained. “Obviously, preventive benefits are oftentimes covered for everyone, and so really understanding what’s included in that and what you have that coverage for.”
Edwin is a reporter and producer in North Tonawanda, New York. He’s previously reported for the Niagara Gazette and the Ithaca Times. Edwin got an early start in radio interning for WBFO-88.7FM, NPR’s Buffalo affiliate. In 2018, he graduated from SUNY Buffalo State College with a B.A. in Journalism, and in 2022, graduated from Syracuse University with an M.S. in Communications.