New York uses NY State of Health (nystateofhealth.ny.gov) for enrollment, not the federal HealthCare.gov. You can't enroll through the federal site.
All plans use community rating: your premium is based on your age, region and household size. Health history and pre-existing conditions don't affect your rate. A 60-year-old with chronic conditions pays the same as a healthy 60-year-old in the same plan and region. New York also bans PPO plans in its individual market. Every plan sold here is an HMO, EPO or INN. Out-of-network care is not covered except in emergencies. New York prohibits tobacco surcharges, so nonsmokers and smokers pay identical premiums for the same plan.
New York's Essential Plan covers enrollees earning up to 250% of the federal poverty level at $0 a month in premiums. On July 1, 2026, that income ceiling drops to 200%, and approximately 450,000 enrollees will lose that coverage and need to move to a Marketplace plan. Single-person households earning between $31,920 and $39,900 should check their status at NY State of Health before July 2026.











