New York Health Insurance 2026
Health insurance in New York is sold through NY State of Health, with an estimated 100-160 plans available for 2026. The average Silver-tier premium is $440/mo before subsidies for a 40-year-old non-smoker. Medicaid status: Expanded.
Marketplace
NY State of Health
NY State of Health
Avg Silver Premium
$440/mo
Before tax credits, age 40
Medicaid
Expanded
Affordable Care Act status
New York 2026 Health Insurance Quick Facts
| Field | Value | Notes |
|---|---|---|
| Marketplace | NY State of Health | State-run exchange |
| Open Enrollment 2026 | Nov 1, 2026 – Jan 31, 2027 | Special enrollment for QLEs year-round |
| Plans available | 100-160 | Bronze/Silver/Gold/Platinum tiers |
| Medicaid expansion | Expanded | Up to 138% FPL |
Premium and plan counts are estimates for 2026 based on prior-year filings and pending rate approvals. Always verify pricing on the marketplace itself before enrolling.
NY State of Health: Pure Community Rating and the Essential Plan
New York's NY State of Health is one of the nation's largest and most innovative state-based exchanges, with 100–160 plans statewide. New York uses pure community rating, meaning premiums cannot vary by age — a rule more protective than the ACA's 3:1 age band, making coverage more affordable for older residents but more expensive for the young. Oscar, Molina, and MetroPlus (a New York City public plan) are among the top marketplace carriers. Silver premiums average $430–$455/month before subsidies for a 40-year-old, though this masks significant variation between NYC and upstate markets. The open enrollment window extends through January 31.
New York was an early Medicaid expansionist and operates one of the most generous public coverage programs, including the Essential Plan — a near-zero premium option for adults earning 100–200% FPL that has enrolled over 1 million New Yorkers. New York also expanded Medicaid to cover all income-eligible adults including undocumented immigrants for emergency services and, in recent years, expanded state-funded health programs for broader immigrant populations. New York's Medicaid and Essential Plan together cover millions of New Yorkers, and the state's uninsured rate is among the lowest nationally.
What to Know About Health Insurance in New York
Top marketplace carriers
Leading 2026 ACA carriers in New York: Oscar Health, Molina Healthcare, MetroPlus Health Plan. Plan selection and network breadth vary widely by ZIP code — use the marketplace's plan-finder tool with your ZIP and household income for accurate availability.
Notable state rule
New York requires insurers to use pure community rating (no age rating), making premiums unusually flat across age groups, and operates the Essential Plan for residents below 200% FPL.
Medicaid eligibility
New York expanded Medicaid under the ACA. Adults under 138% of the Federal Poverty Level (FPL) qualify — about $20,800/yr for an individual or $43,000/yr for a family of 4 in 2026.
New York Pro Tip
Health Insurance FAQs — New York
Who runs the health insurance marketplace in New York?
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New York operates its own state-based exchange called NY State of Health at nystateofhealth.ny.gov.
How much does Silver-tier health insurance cost in New York before subsidies?
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A 40-year-old non-smoker in New York typically pays about $430–$455/month for a Silver plan before subsidies. Unusually, New York uses community rating so premiums don't vary as much by age as in other states.
Is Medicaid expanded in New York?
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Yes. New York expanded Medicaid broadly and also offers the Essential Plan (near-zero premium) for residents earning 100–200% FPL. Adults earning up to 138% FPL are generally Medicaid-eligible.
Related Guides
Marketplace data sourced from state and federal exchange filings for New York, April 2026. Premium estimates are 2026-projected.
Jennifer Walsh
Editorial Lead, Health & Medicare
This article was researched and written by the Cover Forge USA editorial team against federal sources (NAIC, CMS, FEMA, DOL, SSA, state DOIs) and standard policy forms. Bylines organize content by topic — they do not assert individual licensure. See our editorial-policy for details.
Reviewed April 2026
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