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Deadline approaches for health insurance enrollment

New York State Department of Health
The deadline to enroll in a health insurance plan through New York's state marketplace is Saturday.

This is a busy time of year for Margarita Gonzalez. She’s an insurance navigator at Trillium Health in Rochester, and with the enrollment period for New Yorkers to get health coverage through the state’s marketplace ending Saturday night, she’s been getting a lot of calls.

“I probably touched base with five clients this morning,” Gonzalez said just after noon on Friday, “and I’ll probably have at least five more today.”

Gonzalez said a lot of people want quick answers—but getting enrolled in an insurance plan is not often a quick process. Different people qualify for very different plans.

“It depends on how many individuals are in your households, what is your annual income. If you have any additional income; if you’re collecting social security; if you’re collecting unemployment. There’s a lot of components,” Gonzalez said.

She laid out a few categories of people who stand to benefit from buying insurance through New York State of Health, the state’s insurance marketplace.

For people who don’t have insurance through their employers – or for people who do have that coverage but find the monthly costs too high – the state insurance marketplace might offer a more affordable option, Gonzalez said.

Households whose income is within four times the federal poverty line (just over $100,000 for a family of four) qualify for at least some assistance from tax credits or programs like Medicaid if they get insurance through the state marketplace.

Even billionaires whose income puts them at the very top of American earners can still buy insurance through the state marketplace – although Gonzalez said they’ll probably end up paying more than if they went through their employers, since monthly premiums are based on income.

Gonzalez said the detailed form that enrollees need to fill out can be frustrating, but in the end, she’s able to help a lot of people. She told WXXI News about one recent client who started out feeling hopeless and left grateful.

“It was so rewarding. She just looks at me, and she says, ‘Can I give you a hug,’ and I’m like, ‘Sure, sure.’ I get a lot of hugs throughout the day and it makes you feel good.”

As part of last year’s federal tax bill that revised the Affordable Care Act passed under President Barack Obama, there’s now no penalty on federal taxes for not having health insurance, but there is a state penalty in New York.

If you miss the Saturday deadline, New York is one of a handful of states that lets you enroll on the state exchange through January 31. You just won’t have coverage until February.

The New York State of Health website has phone numbers and online chat assistance for people looking for help.

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