BUSINESS SPOTLIGHT

Spotlight on… NYS of Health Marketplace Program Nava Sivan, Program Director

Business Name: Yeled V’Yalda 

Number of Employees: 6

Years in Business for the NYS of Health Marketplace: 6

Location: 4 sites throughout Brooklyn and 1 in Staten Island

What are the different programs you offer? 

New York State of Health (NYSOH) offers a plan for everyone. One of the programs is Medicaid, which is free and includes medical, dental, and vision. For minors with family income over the tier to qualify for Medicaid, we have Child Health Plus, which is for children ages to 0 to 18 with a monthly premium of $9 based on the size of the family and income. For adults ages 19 – 64, there are the Essential Plans (again, only those over the Medicaid income limit), which are subsidized programs offering medical coverage starting at $20, but for an additional $23 enrollees can get dental and vision as well.  For those who are worried they are not eligible for any programs due to their high income, we offer Qualified Health Plans (QHPs). 

YVY’s health insurance program through NYSOH is quite popular, why is that so? 

Besides for those that qualify for free subsidized (Medicaid) programs,  there are those who have higher incomes but still cannot get coverage through their employers, and there are the self-employed, these individuals will be able to apply through us.  Our experienced navigators will make sure to match them with the best health plan to fit their needs. 

What’s the difference between YVY’s health insurance programs through the NYS of Health and HRA programs?

We offer a variety of programs based on family size and income, as opposed to HRA, which offers only Medicaid.  

What population do you serve?

We are here to serve everyone! We are here to help individuals ages 0 to 64 regardless of their income or family size, and we do so free of charge. Each applicant will fall under different programs through the NYS of Health based on their income and household composition. 

Can Medicare recipients also apply through your department at YVY?

No. Unfortunately, that population cannot be enrolled through our system. The application process for Medicare is done through the Social Security Administration (SSA).  

How do applicants know which plans are best for them? Can they switch if they are unhappy?

The NYS of Health’s database system matches applicants to the program which they qualify to based on their household size and income. Each recipient chooses a plan that is best suited for him based on his doctors and needs.  If he chooses a plan and is dissatisfied, he can switch insurance plans, but not program eligibility. Program eligibility changes if or when income and household composition changes. 

Why can’t people just apply on their own? 

When people apply by themselves, they can mess-up the paperwork by entering the incorrect information and then they are locked in the system.  Errors can delay the application process.  It is better to apply with our navigators since they are trained and are more qualified to fill out, advise, and guide the applicant ensuring a smooth and efficient streamlined process.

What kind of training do your navigators have to go through, and what are their credentials?

All navigators must pass a rigorous training program, and in the end, they receive a certificate through the NYS of Health. The navigators continue having trainings on a regular basis learning about changes and updates of the different health insurance programs.  This ensures that all our navigators are well- informed and therefore can continue providing the best assistance to our clients.  

Have you seen an increase in enrollees due to the pandemic?

Yes. There are still too many individuals out there without proper coverage, and they need outside help. Many of these people either lost their jobs, and/or lost their private insurance due to loss of hours at their current job. These people can come to us and we will gladly help them apply based on their current income and family size.

What about people who are nervous about COVID-19 and do not want to apply in person? 

During regular times, this is usually done in a facea to face meetings because we need to see certain legal documents, but due to the pandemic, the DOH has approved over the phone applications. Any important documents that we need to see can be faxed or emailed to us. If, however, one does feel comfortable and wants to see us in the office, they can meet one of our navigators, but it can ONLY be done by scheduling an appointment. If anyone wants to schedule an appointment, or has any questions, they can call us at any site of their choice.