Qualified Health Plans: NY State of Health
Qualified Health Plans (QHPs) through NY State of Health (NYSOH) offer flexible, private health insurance in Bronze, Silver, Gold, and Platinum tiers. NY Health Insurer’s licensed brokers help you compare plans and maximize subsidies—call (888) 215-4045 for a free quote.
What Are Qualified Health Plans?
Qualified Health Plans (QHPs) are private health insurance plans offered through NY State of Health, designed to meet Affordable Care Act (ACA) standards. Available in Bronze, Silver, Gold, and Platinum tiers, QHPs cover essential health benefits, including hospital care, doctor visits, prescriptions, mental health services, maternity care, and preventive care like vaccinations and screenings. As of 2025, nearly 195,000 New Yorkers are enrolled in QHPs, with many benefiting from premium tax credits and cost-sharing reductions to make coverage affordable.
QHPs are ideal for individuals, families, and small businesses seeking customizable coverage with access to diverse provider networks across New York. Unlike public programs like Medicaid or the Essential Plan, QHPs have no upper income limit, making them accessible to a broad range of residents, from freelancers in Brooklyn to retirees in Buffalo. NY Health Insurer, a trusted broker since 2013, simplifies the process by offering instant plan comparisons, verifying in-network providers, and securing subsidies to lower your costs.
With QHPs, you can select plans tailored to your healthcare needs and budget. For example, Bronze plans suit healthy individuals with minimal medical needs, while Platinum plans are ideal for those requiring frequent care. Our quoting tool provides real-time comparisons, ensuring you find the right plan without leaving our platform, and our brokers guide you every step of the way.
Learn more about NYSOH: NY State of Health Overview | Essential Plan | Child Health Plus
Why Choose NY Health Insurer for QHPs?
Selecting a QHP can be complex, but NY Health Insurer makes it easy with expert guidance and free support. Here’s why we’re the preferred choice for New Yorkers:
- Expert Brokers: Our certified team is trained to navigate NYSOH’s QHP options, ensuring you choose a plan that fits your healthcare and financial needs.
- Instant Quotes: Our quoting tool offers real-time plan comparisons based on your zip code, income, and preferences, saving you time and effort.
- Provider Verification: We check in-network doctors and hospitals before you enroll, ensuring your preferred providers are covered.
- Multilingual Support: Assistance is available in multiple languages, reflecting New York’s diverse communities.
- Trusted Since 2013: We’ve helped thousands secure QHPs with maximum subsidies, saving clients thousands annually with no hidden fees.
For example, a Brooklyn freelancer we assisted in 2024 enrolled in a Silver QHP with cost-sharing reductions, saving $2,400 annually while accessing Mount Sinai providers. Start your journey to affordable coverage today.
Understanding QHP Tiers
QHPs are categorized into four metal tiers, each balancing monthly premiums and out-of-pocket costs. Here’s a detailed comparison to help you choose:
| Tier | Premiums | Out-of-Pocket Costs | Best For |
|---|---|---|---|
| Bronze | Lowest | Highest (high deductibles, copays) | Healthy individuals with minimal medical needs |
| Silver | Moderate | Moderate (eligible for cost-sharing reductions) | Those with regular medical needs, seeking subsidies |
| Gold | Higher | Lower (lower deductibles, copays) | Frequent healthcare users |
| Platinum | Highest | Lowest (minimal out-of-pocket costs) | Those with extensive medical needs |
A Buffalo family we helped in 2024 chose a Gold QHP, reducing out-of-pocket costs by $3,000 annually for their chronic care needs. Compare QHP tiers with our quoting tool to find the best fit for your lifestyle.
Benefits of QHPs
QHPs provide comprehensive coverage required by the ACA, ensuring you’re protected for a wide range of healthcare needs. Key benefits include:
- Hospital Care: Covers inpatient and outpatient services, including surgeries, hospital stays, and emergency care.
- Doctor Visits: Includes primary care, specialist consultations, and preventive services like vaccinations and cancer screenings.
- Prescriptions: Provides coverage for generic and brand-name medications, with copays varying by plan tier.
- Mental Health: Offers therapy, counseling, and psychiatric care, addressing the growing need for mental health support.
- Maternity Care: Includes prenatal, delivery, and postnatal care for expecting parents.
- Rehabilitation: Covers physical therapy and other services for recovery from injuries or surgeries.
Unlike the Essential Plan, which focuses on low-income residents, QHPs offer broader provider networks, making them ideal for those needing specific doctors or hospitals. A Manhattan executive we assisted in 2024 enrolled in a Platinum QHP, ensuring access to top specialists at NYU Langone. Learn more about NYSOH programs.
Financial Assistance for QHPs
Over 70% of QHP enrollees qualify for financial assistance, significantly lowering costs. Available subsidies include:
- Premium Tax Credits: Reduce monthly premiums for incomes 250%–400% FPL ($37,650-$60,240 for a single adult in 2025). A Syracuse couple saved $2,800 annually on a Silver QHP in 2024.
- Cost-Sharing Reductions: Lower deductibles, copays, and coinsurance for Silver QHPs (250%–400% FPL, $60,240 for a single adult). A Queens family reduced copays by $1,200 with this subsidy.
Our quoting tool calculates your subsidy eligibility instantly, ensuring you maximize savings. A Long Island small business owner we helped in 2024 qualified for $4,800 in tax credits, making a Gold QHP affordable.
How to Enroll in QHPs
Enrolling in a QHP through NY Health Insurer is straightforward:
- Enter Your Zip Code: Use our quoting tool to view QHPs available in your area.
- Provide Details: Input income, household size, and healthcare preferences to filter plans.
- Compare Plans: Review Bronze, Silver, Gold, or Platinum tiers with real-time subsidy estimates.
- Apply: Complete your application via our secure portal, guided by our brokers.
- Renew: Update annually by December 15 for January 1 coverage.
QHP enrollment is available during open enrollment (November 1–January 31) or special enrollment periods for qualifying events like marriage, job loss, or childbirth. A Rochester retiree we assisted enrolled in a Platinum QHP during a special enrollment period after losing employer coverage, securing coverage in just 20 minutes. Read our enrollment guide for more details.
Regional QHP Options
QHP providers vary by region, offering tailored networks to meet local needs:
- New York City: MetroPlus and Healthfirst provide QHPs with access to NYC Health + Hospitals. A Bronx client chose a Silver QHP for $200/month after subsidies in 2024.
- Upstate New York: Excellus BlueCross BlueShield offers extensive rural networks. A Syracuse family enrolled in a Gold QHP, saving $3,600 annually.
- Long Island: Fidelis Care provides competitive QHPs. A Nassau County couple saved $2,000 on a Bronze QHP in 2024.
- Western New York: Independent Health is popular in Buffalo, offering robust QHPs. A retiree enrolled in a Platinum QHP for comprehensive care.
Explore NYC QHPs or contact us to verify providers in your region.
Member Stories: Real New Yorkers, Real Savings
Sarah’s Story: Brooklyn Freelancer
Sarah, a 32-year-old freelancer, enrolled in a Silver QHP with cost-sharing reductions through NY Health Insurer. “I saved $2,400 a year and kept my Mount Sinai doctor,” she says. Our brokers completed her enrollment in 25 minutes.
Michael’s Story: Syracuse Family
Michael, a Syracuse father, chose a Gold QHP for his family, saving $3,600 annually with tax credits. “NY Health Insurer made it easy to compare plans,” he shares, appreciating the Excellus network coverage.
Call (888) 215-4045 to start your QHP journey.
Frequently Asked Questions
What are QHPs?
QHPs are private health insurance plans offered through NY State of Health, available in Bronze, Silver, Gold, and Platinum tiers, covering essential health benefits like hospital care and prescriptions.
Who qualifies for QHP subsidies?
Individuals and families with incomes 250%–400% FPL ($37,650-$60,240 for a single adult in 2025) qualify for premium tax credits; those up to 400% FPL get cost-sharing reductions.
When can I enroll in a QHP?
Open enrollment is November 1–January 31, or during special enrollment periods for qualifying events like marriage or job loss.
How do I choose the right QHP tier?
Consider your healthcare needs and budget. Bronze suits minimal needs, while Platinum is best for frequent care. Our brokers help you compare tiers.
Get Covered with QHPs
Find the perfect QHP with NY Health Insurer’s expert guidance. Call (888) 215-4045 to explore your options.
Get a quote now to compare QHPs.
For more information, call (888) 215-4045 or visit nyhealthinsurer.com.