Why Healthy NY Costs Less than Traditional Health Insurance Plans
Many employers have found themselves pondering why the Healthy New York insurance policy costs less than traditional insurance plans. The answer to the question is not why, but rather how. The Healthy New York insurance plan does not cover numerous unnecessary benefits that are characteristic of traditional policies. The Healthy NY plan denies coverage of mental health, home health care, chiropractors, and treatment for alcohol and substance abuse. The denial of these treatments results in lower premiums when compared to conventional policies. Along with the denial of certain treatments, Healthy NY also has higher deductibles and cost sharing in comparison with these traditional polices.
This characteristic decreases the demand for unneeded medical care and shifts the majority of the costs to those in need of the care. Along the same lines, Healthy NY also has an in-network requirement and services are only covered when conducted by a physician in the network of certified providers. This essentially drives down the rate of increase in the price of premiums for all the enrollees and decreases the chances of insurance abuse or fraud. The Healthy NY plan also has a stop-loss provision which covers up to 90% of annual claims for any individual with costs at $100,000 or less. This reassures carriers that any individual’s medical costs will be paid and results in a lower premium for all participants in the Healthy New York plan. By centering the Healthy NY plan on the concerns of those insurances carriers, it has in effect lowered the price for all participants and businesses. The goal of Healthy NY is not to make money off the participants, but rather to create an insurance plan that caters to the participants and carriers alike.