Need Insurance Coverage? You’re Not Alone

“Today nearly 2.7 million New Yorkers (about 16 percent) under age 65 do not have health insurance coverage. Most uninsured are workers and their families who earn too much to qualify for public programs like Medicaid, but not enough to buy coverage on their own.”

– Urban Institute, Health Insurance Policy Simulation Modeling, 2012

Under the federal Affordable Care Act, a marketplace will be operating in every state starting in this month. States have the option to either set up a marketplace or to allow the federal government to set up a marketplace in their state. New York has chosen to set up its own marketplace, called NY State of Health. (Previously, it was called the New York Health Benefit Exchange.) On April 12, 2012, Gov. Andrew Cuomo issued Executive Order 42 to establish it within the NYS Department of Health. On July 9, 2012, Cuomo submitted a declaration letter to the Centers for Medicare & Medicaid Services confirming New York’s intent to establish a state-based Health Plan Marketplace consistent with the Affordable Care Act.

NY State of Health is an organized marketplace designed to help people shop for and enroll in health insurance coverage. Individuals, families and small businesses will be able to use the marketplace to help them compare insurance options, calculate costs and select coverage online, in-person, over the phone or by mail. The marketplace will help people to check their eligibility for health care programs like Medicaid and sign up for these programs if they are eligible. The marketplace will also be able to tell what type of financial assistance is available to applicants to help them afford health insurance purchased through the marketplace. Insurance coverage can be purchased through NY State of Health and can be effective starting Jan. 1.

NY State of Health will not affect Medicare coverage. The marketplace is intended to help New Yorkers who are not eligible for Medicare get health insurance coverage.

In-Person Assistors (IPAs)/Navigators will provide in-person enrollment assistance to individuals, families, small businesses and their employees who apply for health insurance through the exchange.

Modeled on successful community assistance programs in New York, the IPA/Navigator program is designed to meet the needs of New Yorkers by providing assistance in convenient, community-based locations. IPAs/Navigators will provide culturally competent, linguistically appropriate and disability accessible enrollment services. They will be available at convenient times, including evenings and weekends, at no cost to enrollees.

IPAs/Navigators will:

Provide in-person assistance to those applying for health insurance coverage at the time of initial application and at annual renewal

Offer information on the types of health insurance programs available through the Exchange

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Provide application assistance for private and public health insurance programs and advance premium tax credits and cost-sharing reductions

Refer consumers to other organizations for help with grievances, complaints or questions regarding health coverage or a determination related to coverage

Supply information in a fair and impartial manner which is culturally and linguistically appropriate, and disability accessible, including for individuals with limited English proficiency.

As required by federal law, the IPA/Navigator program will be an ongoing feature of the Exchange. You can reach NY State of Health by calling us toll free at 1-855-355-5777. Customer service hours of operation are: Monday-Friday 8 a.m. to 5 p.m. and expanded hours 8 a.m. to 8 p.m. Monday through Friday and 9 a.m. to 1 p.m. Saturdays. Chautauqua County navigators at Chautauqua Opportunities can be reached at Jamestown/Mayville area 661-9430 and in the north county at Connections North 366-8176. You are advised to call for an appointment. If you have questions about health plans, financial assistance, or anything else about NY State of Health, please call our customer service representatives at 1-855-355-5777, or the local numbers listed.

Chautauqua County Office for the Aging offers health insurance counseling for people signing on to Medicare and open enrollment to change types of plans. You can contact NY Connects to speak with our operator to locate the closest office to you and help you set an appointment with a health insurance counselor. This program is funded by your donations. Senior Life Matters located in the south county also offers health insurance counseling and can be reached at 720-9797. There is an hourly rate and appointments are required.

NY Connects is an information and assistance telephone service provided by the state for people of all ages, who have ongoing health problems and needs. This service is confidential, free and focused on the consumer’s needs and resources available to them. NY Connects promotes independence, dignity, and supports those in need of long term care and supports to remain in their homes and communities for as long as possible. NY Connects can assist you even further by making referrals directly to several programs even while you are on the phone, saving you time and additional phone calls. Connecting people with helpful services and programs is what NY Connects does.

You can access Chautauqua County New York Connects in many ways to fit your needs. Email: ccnyc@co.chautauqua.ny.us; call the Mayville number 753-4582, Dunkirk number 363-4582 or Jamestown number 661-7582; or fax 753-4477. You can even come to our main office location at 7 N. Erie St. in Mayville in the HRC building at the county seat offices. NY Connects is brought to you by the Chautauqua County Office for the Aging and the Chautauqua County Department of Health and Human Services.