The 20-Minute Renewal Checklist for NY State of Health

Before you start: what to have on the table

The renewal notice from NY State of Health and your carrier, which arrives in the fall and says what your plan will cost and whether anything is changing. Your insurance card, so you have the exact plan name. A list of every doctor you saw in the last two years, your pharmacy, and every prescription with its dose. And a number: what you expect your household to earn in 2027, not what your 2025 tax return says.

If you do not have the notice, log in to your NY State of Health account or call 1-855-355-5777. If you moved and never updated the address, do that first, because the notice went to the old apartment.

The checklist

• Read the new premium, not last year's. The 2027 individual-market rates approved by the state average about 6% higher, but your plan's change can be larger. The number that matters is on the notice.
• Update your projected income for 2027. The tax credit is built on it. A wrong guess in either direction costs money: too low and you repay at tax time, with no cap on the repayment since 2026; too high and you overpay all year.
• Check the credit line separately from the premium line. If your credit fell more than your premium rose, the plan is more expensive even though the sticker barely moved. That is the 2026 and 2027 pattern.
• Call your primary care doctor with the exact 2027 plan name. "Are you in network for [carrier] [exact plan name] for 2027, and are you taking patients under it?" Directories are stale; the front desk knows.
• Call every specialist you expect to see next year. Same question. Networks are decided plan by plan, not carrier by carrier.
• Look up each prescription on the 2027 formulary. Note the tier. A drug moving from tier 1 to tier 3 is the most common hidden increase.
• Ask the pharmacy if it is still in network. Pharmacy networks change too, and the answer at the counter in February is expensive.
• Compare metal levels against how you actually used care. If you never met the deductible, a lower metal may cost less overall; if you had a hospital stay or ongoing treatment, a higher metal may. The [marketplace guide](/coverage/marketplace/) has the table.
• Check whether your household still belongs in this program at all. Income at or below 200% of the poverty level and age 19 to 64 usually means the Essential Plan, at $0 and with no season. Under roughly 138%, Medicaid. Children almost always qualify for Child Health Plus. [The 2026 limits](/coverage/income-limits-2026/).
• Check who else in the household has a different calendar. Anyone on Medicare is on the October 15 to December 7 window, and their notice is a separate document.
• Decide, then confirm the effective date in writing. A change made by December 15 takes effect January 1. A change made January 20 takes effect February 1, which leaves January on the old plan.
• Save the confirmation. Screenshot or print the confirmation page with the plan name, the premium after credit and the start date.

The three calls, with the words

To a doctor’s office. “I’m reviewing my plan for 2027. Are you in network for [carrier] [exact plan name], and are you accepting patients under that plan? Which hospital would you send me to for a procedure?” Write down who answered and the date.

To the pharmacy. “Is this pharmacy in network for [carrier] [exact plan name] in 2027, and is [drug, dose] on the formulary, and at which tier?” If the answer is a shrug, the carrier’s member services line can read the formulary to you.

To NY State of Health, 1-855-355-5777. “I want to update my projected 2027 income and see how the credit changes. And please confirm the address and email on my account.” This is also where you ask whether you qualify for cost-sharing reductions, which attach only to silver plans and only at certain incomes.

What to do if the plan you had is gone

Carriers withdraw plans between years, and the marketplace maps you to the closest replacement. The replacement is a guess. Treat it as a new enrollment: run the network calls above against the new plan name, not the old one, because “closest” is measured by the carrier’s benefit design, not by whether your cardiologist participates.

What this checklist does not cover

Employer coverage, which has its own open enrollment at your job and its own rules about when you may switch to the marketplace. Medicare plan selection, which is a different comparison entirely and is covered in Medicare in New York. And plan quality ratings, which we do not use, because the rating that predicts your year is whether your doctors and your drugs are in it.