Insurance Rights - OCHIA

Human Resources Administration-Office of Citywide Health Insurance Access


Affordable Care ActInsurance RightsHealth Care Rights


Insurance Rights

New Yorkers have special health insurance rights.

Surprise Medical Bills Protections

Under New York law, most people are protected from surprise bills from doctors, hospitals, and other health care providers when they haven't given you all of the required information about your care. For example, you may be protected if you have surgery at a facility that is in your insurance plan network, but you later receive a surprise bill for an out-of-network service (like an anesthesiologist). You may also be protected if you go to an emergency room that is not in your health plan's network.

Learn more about New York's Surprise Bills Law

Managed Care Bill of Rights

Managed care health insurance plans usually require that you seek care from a group of doctors in the plan's "network." You usually have to select a primary care doctor or PCP, who will coordinate your health care. If you have a managed care plan, you have certain health care rights, like the right to go to the emergency room without getting approval in advance. This is called the Managed Care Bill of Rights.

View the full Managed Care Bill of Rights

Health Insurance Rights for Transgender Individuals

Private Insurance

Private insurance companies in New York can't deny medically necessary treatment for gender dysphoria, if they cover the same treatment for other conditions. This means that if you need a treatment like a mastectomy for gender affirming surgery, your health plan can't decide not to pay for it just because you are a transgender person.

Read the press release from the Department of Financial Services

Health Coverage Information for Transgender New Yorkers

Helpful Links

Learn more about your health insurance rights from the Department of Financial Services
Learn about your rights under the Affordable Care Act
Learn about your health care rights