Private PPO, off-exchange & NY State of Health plans for you, your spouse and your kids — compared side by side for 2027
▶Watch: Private PPO vs. ACA Marketplace — which is right for your family (50 sec)
Is your family overpaying for health insurance in New York? If your household earns more than $132,000 (family of four), NY State of Health gives you no federal premium help for 2027 — and New York's family premiums are among the highest in the country. New York prices family coverage by tier rather than by person, with no discount for younger parents, so the full-price family bill lands hard. That's where families overpay the most, and where comparing every route — including employer-level group PPO coverage and Child Health Plus for the kids — pays off.
For 2027 coverage, federal premium tax credits stop completely once household income passes 400% of the federal poverty level. Find your household size:
| Household size | No federal premium help above |
|---|---|
| 2 (you + spouse, or parent + 1 child) | $86,560 |
| 3 | $109,280 |
| 4 | $132,000 |
| 5 | $154,720 |
| 6 | $177,440 |
Thresholds use the 2026 federal poverty guidelines, which apply to all 2027 marketplace coverage. Income means your household's projected 2027 modified adjusted gross income (MAGI).
New York plans are priced as individual, couple, parent-plus-children, or couple-plus-children. Your third or fourth child doesn't raise the premium — but there's also no discount for younger parents.
Child Health Plus covers children under 19: free below 222% of the poverty level, $15–$60 per child up to 400% (capped at $180 a month per family), and a full-price buy-in above that.
New York lets parents keep unmarried adult children on a family policy through age 29 for an added premium — useful for recent grads without a job-based plan.
Usually the best value if your family is under the cliff and qualifies for a meaningful subsidy — and the place to apply for Child Health Plus or Medicaid for the kids.
The same carriers and protections, bought directly. Most New York individual plans are HMOs or EPOs, so checking your pediatrician and children's hospital is essential.
True group coverage for the self-employed, freelancers and small-business owners that covers your spouse and children — on the Aetna and First Health networks, plus MagnaCare in New York. Pre-existing conditions covered and year-round enrollment. Subject to eligibility. See the plans →
Before you enroll, we confirm your pediatrician, specialists and nearest children's hospital are in-network:
Morgan Stanley Children's Hospital (NewYork-Presbyterian), Hassenfeld Children's Hospital at NYU Langone, Mount Sinai Kravis Children's Hospital, and the Children's Hospital at Montefiore.
Cohen Children's Medical Center (Northwell), Stony Brook Children's, and Maria Fareri Children's Hospital at Westchester Medical Center.
Golisano Children's Hospital in Rochester and Syracuse, Oishei Children's Hospital in Buffalo, and Bernard & Millie Duker Children's Hospital at Albany Med.
Shopping for yourself or your spouse only? See our guide to private health insurance in New York.
Ages of you, your spouse and each child, your ZIP code, and your estimated 2027 household income.
Your pediatrician, family doctor, specialists and preferred hospital — checked against every network we quote.
NY State of Health plans, Child Health Plus, off-exchange ACA plans, and employer-level group PPO options — total family cost, deductibles and networks on one page. One call, one comparison, no cost to you.
New York prices family coverage by tier, not by each person's age, so a couple-plus-children policy runs roughly 2.85 times the single rate for the same plan whether you have one child or several. Premiums vary by region and plan, and regulators approved an average 6% increase for 2027. We quote your exact family at your ZIP code across every carrier and route.
Only if your household income is at or below 400% of the federal poverty level: $86,560 for two, $109,280 for three, $132,000 for four, $154,720 for five, and $177,440 for six. Above that, no federal premium tax credit is available for 2027 coverage.
Yes. Children under 19 can enroll in Child Health Plus at any income. It's free below 222% of the poverty level, costs $15 to $60 per child per month up to 400% (no more than $180 per family), and above 400% families can buy in at the full premium — which can still be cheaper than adding kids to a private plan.
True PPOs are scarce in New York's individual market, where most plans are HMOs or EPOs. Employer-level (ERISA) group PPO coverage is another route that covers your spouse and children on national networks for those who qualify.
Every ACA-compliant plan covers pre-existing conditions with no medical questions, and employer-level (ERISA) group plans cover pre-existing conditions as well, just as with any employer coverage.
NY State of Health open enrollment runs November 1, 2026 through January 31, 2027 — enroll by December 15 for coverage starting January 1. Child Health Plus enrolls year-round, a new baby, adoption, marriage or loss of coverage opens a 60-day special enrollment window, and employer-level group plans enroll year-round for those who qualify.
No. Premiums are identical with or without an agent — carriers pay us, not you. The family comparison and enrollment help are free.
Get Your Family's 2027 New York Health Quote
Free side-by-side comparison from a licensed advisor — NY State of Health, Child Health Plus, off-exchange and employer-level PPO options for your whole household.
Get My Family's Options Call (800) 939-3330
Prefer to talk first? Book a 15-minute family plan review.
Subsidy thresholds use the 2026 HHS poverty guidelines, which apply to 2027 coverage. The 2027 rate figure is the approved average published by the New York State Department of Financial Services; the family-tier ratio reflects NY State of Health's published benchmark premiums by coverage type. Child Health Plus premiums per NY State of Health guidelines. Employer-level group plan availability subject to eligibility requirements. Premiums vary by region, plan, and family tier.
