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This document is an application for individuals and sole proprietors seeking to enroll in the Healthy NY health insurance program, including details on eligibility, required information, and submission
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How to fill out Healthy NY Application for Individuals and Sole Proprietors

01
Gather necessary personal information including name, address, and Social Security number.
02
Collect income documentation such as recent pay stubs or tax returns.
03
Decide on the type of coverage needed (individual or family).
04
Fill out the application form accurately, ensuring all sections are completed.
05
Provide any additional information requested, such as household size and health history.
06
Review the application for any errors or missing information before submission.
07
Submit the application to the designated Healthy NY office, either online or by mail.
08
Keep a copy of your application and any correspondence for your records.

Who needs Healthy NY Application for Individuals and Sole Proprietors?

01
Individuals and sole proprietors who do not have access to affordable health insurance.
02
Self-employed individuals seeking health coverage options.
03
People seeking assistance with their health insurance costs due to low income.
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Eligibility and Cost Family ContributionsMonthly Income by Family Size* (Effective for applications received on or after 2/15/2025) 12 Free Insurance $2,896 $3,913 $15 Per Child Per Month (Maximum of $45 per family) $3,261 $4,407 $30 Per Child Per Month (Maximum of $90 per family) $3,913 $5,2883 more rows
Medicaid: Depending on how much money you make, you might qualify for Medicaid, which is a public health insurance for people with low incomes. Undocumented immigrants age 65 and older may now qualify for full Medicaid (as opposed to only emergency Medicaid) depending on income.
Qualified Health Plans are available through NY State of Health to individuals who are: New York State residents. Citizens, lawfully present applicants, and DACA recipients. Not eligible for Medicaid, the Essential Plan or Child Health Plus.
Essential Plan Resources Cost Sharing for Health Care ServicesAnnual individual income: below $15,650 - $23,475Annual individual income: $23,476- $39,125 Monthly Premium $0 $0 Annual Deductible $0 $0 Preventive Care $0 $0 Primary Care Physician Visit $0 $157 more rows
What You Pay Per Month Plan TypeRate Individual $1,081.69 Two Adult $2,163.38 Parent & Child(ren) $1,838.87 Family $3,082.82
The Healthy NY program, in partnership with CDPHP and other insurance companies in New York State, provides comprehensive and affordable health insurance to small businesses. Individuals and sole proprietors are no longer eligible for Healthy NY. Instead, get information about CDPHP individual insurance plans.

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The Healthy NY Application for Individuals and Sole Proprietors is a program designed to provide affordable health insurance options for individuals and sole proprietors who may not qualify for traditional commercial health insurance plans.
Individuals and sole proprietors who wish to enroll in the Healthy NY program to access health insurance benefits are required to file the application.
To fill out the application, individuals and sole proprietors must provide personal information, details about their income, and any existing health coverage. Accurate information is critical for eligibility assessment.
The purpose of the Healthy NY Application is to facilitate access to affordable health insurance for individuals and sole proprietors, ensuring they have necessary medical coverage.
The application must report personal identification details, income information, household size, and any existing health benefits to determine eligibility for the program.
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