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Minimum Income to Qualify for Healthy New York Insurance

Written into law under the Health Care Reform Act of 2000, Healthy New York created a standardized health insurance subsidy for small businesses, individuals and sole proprietors. By providing more affordable health care, Healthy New York is bringing insurance coverage to those who otherwise may not afford it. While there is no minimum income to qualify for coverage, there is a maximum income and other requirements that need to be met for eligibility. Once this maximum income is exceeded you are no longer eligible for coverage through Healthy New York.

  1. Minimum Income

    • There is no minimum income to qualify for Healthy New York. There are, however, other similar programs that cater to individuals and even sole proprietors that have a low income. Family Health Plus, for example, will cover an individual for free as long as they do not exceed a gross annual income of $10,890 per year, as of 2011. The maximum income increases in correlation to family size, where a family of four can earn up to $33,525. This is a cheaper alternative to Healthy New York. For those who qualify, the coverage is free and the only out-of-pocket expenses would be co-payments associated with doctor visits and other medical services.

    Individual

    • To qualify as an individual for Healthy New York, you must be a resident of New York state and either be employed currently or have past employment in the prior 12 months. You must not have had insurance for 12 months prior to application unless there is a special circumstance, such as the loss of employment, a divorce, change of employer or another qualifying specific event. The maximum income for an individual to qualify for coverage is $2,269. This increases in increments as family size increases, allowing a monthly household income of $3,861 for a family of three and $4,657 for a family of four, as of 2011.

    Sole Proprietor

    • Sole Proprietors are treated in the same way individuals are. You must meet the same residency requirements and not be above the maximum household income. As a sole proprietor, there may be fluctuations in your monthly income throughout the year. If one month you earn more than the monthly allowance, this will not result in termination of coverage. Your proof of income will be required on an annual basis for renewal, as long as this stays within guidelines you will be recertified each year.

    Small Business

    • Providing employees with affordable coverage is a challenge for most employers. Healthy New York helps small businesses provide reduced-cost insurance coverage to their employees. The business must meet certain requirements to be eligible to participate in the program. The business must not currently offer comprehensive group coverage; must be located in the state of New York; and have one to 50 employees of which 30 percent must earn an annual income of $40,000 or less, as of 2011. As a business you must also ensure a 50 percent participation rate in the program and contribute half of the premium for employees.

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