- No Cost Preventive Care including vaccines, flu shots, checkups and screenings to keep you and your family healthy.
- Dental, vision and telemedicine coverage options.
- Prescription savings and home delivery.
- Enroll anytime in the Essential Plan.
In less than a minute see if qualify for the Essential Plan or other free or low cost plans. We’ll also email you a free guide to help you shop for health insurance.
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Your eligibility for many state and federal programs is determined by your household income, so please be sure to include all sources of your income.
Your eligibility for the 2021 plan year of New York State or federally-sponsored programs, financial assistance, or tax credits is determined by your household income and size compared to the Federal Poverty Level and other requirements.
For questions about health plans and income eligibility, call Univera Healthcare at 1-888-576-6542.
How to Calculate: Add the total from these sources
- Gross income from employers or self-employement income that you received or anticipate for this entire year
- Total unemployment benefits received or anticipated for this year
- Alimony payments received this year from divorces settled after 12/31/2018
- All Social Security payments this year, including disability, retirement and survivor’s benefits
- Pension or retirement income
- Rental income
- Income from interest, dividends, capital gains and annuities
If you are in a situation where you have not applied or have not yet been approved for unemployment, you can assume that income as zero until you start receiving unemployment benefits.
How to Calculate: Do NOT include these sources
- Child support
- Workers compensation
- Disability payments from an employer
- COVID-19 CARES Act economic stimulus payments or COVID-19 pandemic unemployment compensation received in 2020
Required Information for Eligibility
When applying for health insurance, be prepared with the following information:
- Birth dates
- Social Security numbers
- Citizenship documents, a certificate of naturalization or a permanent resident card
- Driver License of NYS Identification Card
- Most recent federal income tax return if self-employed
- Income verification for the last four weeks.
- Employer-based health insurance information
- User name and password from NY State of Health, if available.
All Univera Healthcare members receive these health care member benefits:
- A large network of doctors, hospitals and pharmacies you know and trust.
- PPO network covers 39 Upstate New York counties
- Includes all major hospitals and strategic physician groups
- A large network of doctors, hospitals and pharmacies you know and trust.
- PPO network covers 39 Upstate New York counties
- Includes all major hospitals and strategic physician groups
Get expert advice from our Facilitated Enrollers, available for phone appointments, and in-person appointments in certain counties. To schedule your appointment, call 1-888-669-3911.
If I'm a Univera Healthcare member, can I make changes to my coverage?
Outside the annual open enrollment period (February 2-October 31), you may qualify to buy or change your health insurance coverage if you experience certain life events, within 60 days in most cases. For Medicare, refer to our Medicare Advantage Timeline for specifics on when you may switch your Medicare coverage.
Life Events include: getting pregnant, having a baby, adopting a baby, change in marital status, moving, losing coverage from your employer, or aging off of a parent’s health plan.
By Phone: For an immediate response, call the number on your Member Card for personalized care. Don't have your card handy? Contact numbers are available here.
When can I buy health insurance?
Individuals and Families (Non-Medicare)
There are two times when you can buy health insurance: Open Enrollment and Special Enrollment Periods.
For Metal level plans (Qualified Health Plans), you can purchase health insurance during Open Enrollment, which is typically between November 1 and January 31. However, due to COVID-19, New York State has extended the deadline for 2021 coverage to December 31, 2021.
If you are eligible for Medicaid, Child Health Plus, or the Essential Plan, you can enroll at any time during the year.
Outside the annual open enrollment period (February 2-October 31), you may qualify to buy or change your health insurance coverage if you experience certain life events, within 60 days in most cases.
Life Events include: getting pregnant, having a baby, adopting a baby, change in marital status, moving, losing coverage from your employer, or aging off of a parent’s health plan.
To talk to one of our dedicated Insurance Advisors today about your options, call 1-888-669-3911.
The Essential Plan | Medicaid | Child Health Plus
Medicare
Eligible individuals can enroll for 2020 coverage from October 15 — December 7.
If you’re turning 65, you can enroll in Medicare from the period that extends 3 months before to 3 months after the month of your 65th birthday. For example, if you turn 65 on July 4, you can enroll anytime between April 1 and October 31.
Please refer to our Medicare Advantage Timeline to view specifics on when you may join or switch your coverage.
I have questions. Can I get help from someone in-person?
4 questions to ask when choosing a health plan
Make sure your medications, including maintenance drugs and contraceptives, are covered by the insurer. Univera Healthcare, for example, covers more than 50 prescription contraceptives. You can review the prescription drug lists covered by our plans at UniveraHealthcare.com
Use our Find a Doctor tool to look for physicians in your area that accept your Univera Healthcare plan.
Ask if the plan covers emergency care anywhere in the world. You may also want to inquire as to whether the plan has a telemedicine program that provides 24/7 access to a doctor by phone or video chat when you have a minor health issue and can't see your physician.
You may be eligible for financial help based on your household income and size. Or, you could qualify for the Essential Plan, for $0 or $20 a month. Use our calculator to see if you qualify.
What online tools are available to help me manage my membership?
Plus, download the Univera Healthcare app for Apple or Android devices for control of your membership on your smartphone or tablet.
Are dental benefits available?
Are there plans for early retirees?
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