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How to fill out New York State Health Insurance Cost Effectiveness Determination Application

01
Obtain the New York State Health Insurance Cost Effectiveness Determination Application form from the official website or local health department.
02
Fill in the applicant's personal information, including name, address, and contact details.
03
Provide detailed information about the health insurance plan being evaluated, including the plan name and type.
04
Include documented evidence of the costs associated with the health insurance plan, such as premiums, copays, and deductibles.
05
Attach any necessary supporting documents that verify the need for the cost-effective determination.
06
Complete the signature section and date the application.
07
Submit the application via mail or online according to the instructions provided.

Who needs New York State Health Insurance Cost Effectiveness Determination Application?

01
Individuals or families seeking to evaluate if their health insurance plan is cost-effective in New York State.
02
Healthcare providers looking to assist patients in determining the financial efficiency of their insurance coverage.
03
Insurance agents or brokers who need to guide clients through the process of insurance cost-effectiveness assessment.
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People Also Ask about

New York State residents. Lawfully present in the U.S. 19-64 years old. Not eligible for Medicaid or Child Health Plus.
The Health Insurance Premium Payment Program (HIPP) is a Medicaid program that allows a recipient to receive free private health insurance paid for entirely by their state's Medicaid program. A Medicaid recipient must be deemed 'cost effective' by the HIPP program of their state.
You can apply for Medicaid, Child Health Plus and the Essential Plan any time of the year through the NY State of Health. Small business employers can offer health insurance coverage to their employees any time of the year through the NY State of Health.
There are three ways to enroll in health insurance through NY State of Health: Apply online through the NY State of Health website. By phone at 1-855-355-5777 (TTY: 1-800-662-1220) With the free help of a trained and certified Enrollment Assistor or Broker.
There are three ways to enroll in health insurance through NY State of Health: Apply online through the NY State of Health website. By phone at 1-855-355-5777 (TTY: 1-800-662-1220) With the free help of a trained and certified Enrollment Assistor or Broker.
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
How much does health insurance cost in New York? Health insurance in New York costs an average of $1,038 per month, but you could pay $247 per month after discounts. Platinum and Gold plans have expensive monthly rates, but you pay less when you visit the doctor or get a prescription filled.

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The New York State Health Insurance Cost Effectiveness Determination Application is a process through which health insurance plans can demonstrate that their proposed services and costs are effective and appropriate for coverage under New York State Medicaid programs.
Health insurance providers or managed care organizations looking to offer plans or services that seek reimbursement from New York State Medicaid programs are required to file this application.
To fill out the application, entities must provide detailed information about the services offered, the cost of those services, demographic information about the target population, and evidence or data supporting the cost-effectiveness of the proposed services.
The purpose of the application is to ensure that the services provided to Medicaid beneficiaries are both cost-effective and of high quality, enabling the state to manage healthcare costs while maintaining access to necessary medical services.
The application must report information such as the proposed service descriptions, costs, expected outcomes, demographic data of the target population, and any prior studies or evaluations that demonstrate the effectiveness of the services.
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