New York · FIPS 36045
Jefferson County, NY — ACA coverage
Marketplace plans, premium tax credit eligibility, and Medicaid options for residents of Jefferson County, New York. Updated 2026-06-08.
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Enrollee count is an estimate derived by evenly distributing the state's CMS plan-select total across counties; actual county enrollment varies with population.
How the Jefferson County estimate is calculated
Methodology: ACA Beacon does not have county-level enrollment dashboards for every U.S. county. To give you a directional sense of marketplace activity in Jefferson County, we take the most recent state-wide Open Enrollment Period (OEP) plan-selection total reported by CMSi (or the state-based marketplace) and divide it evenly by the number of counties in New York.
Formula used here: 221,534 total state signupsi ÷ 62 New York countiesi = ~3,573 estimated enrollees for Jefferson County.
Uncertainty & limitations: Counties vary widely in population, income, and insurer participation. Urban counties typically enroll far more residents than rural ones. This number is a simple average, not a forecast or official CMS county report. Use it as a rough indicator of statewide penetration, not a precise local count.
Last updated 2026-06-08. Data source: CMS OEP state-level plan-selection reports.
ACA marketplace in Jefferson County
Residents of Jefferson County shop and enroll in ACA marketplace plans at nystateofhealth.ny.gov/. Plans are rated by county, so available carriers and prices in Jefferson may differ from elsewhere in New York.
Carriers currently selling in New York include: Fidelis Care, EmblemHealth, Healthfirst, MetroPlus, Excellus BCBS, Independent Health, CDPHP, MVP Health Care, UnitedHealthcare. The final 2027 carrier list for Jefferson County is confirmed when New York filings finalize in summer 2026.
Premium tax credit eligibility
Premium tax credits (APTC) cap your monthly premium for a benchmark Silver plan at a percentage of household income — currently 0% at 150% FPL up to 8.5% at 400%+ FPL while Inflation Reduction Act enhancements remain in effect. Cost-sharing reduction (CSR) Silver plans further reduce deductibles for households under 250% FPL.
Use our free subsidy calculator or see the full New York subsidy & income tables.
Medicaid & CHIP in Jefferson County
Jefferson County residents may qualify for Medicaid up to 138% of the Federal Poverty Level under New York's adopted ACA Medicaid expansion.
Child Health Plus covers children up to 405% FPL; pregnancy Medicaid covers up to 223% FPL. Apply year-round at www.health.ny.gov/health_care/child_health_plus · 1-800-698-4543.
Open Enrollment & SEP
2026 OEP in New York: November 1, 2026 – December 15, 2026. Missed it? You may still enroll within 60 days of a qualifying life event (job loss, marriage, birth, move, income change). See New York OEP & SEP details.
Other New York counties
Sources
- New York marketplace(opens in a new tab)
- HealthCare.gov subsidies(opens in a new tab)
- KFF Medicaid expansion tracker(opens in a new tab)
- U.S. Census county FIPS reference(opens in a new tab)
- CMS CHIP & Medicaid(opens in a new tab)
- CMS OEP state-level plan-selection reports(opens in a new tab)
- CMS 2026 Star Ratings(opens in a new tab)
The information contained on this website is for educational purposes only. We are not responsible for missing or inaccurate information. Please consult a licensed insurance broker in your state and area for insurance advice. Please consult a CPA for tax or legal advice.