New York · FIPS 36081

Queens County, NY — ACA coverage

Marketplace plans, premium tax credit eligibility, and Medicaid options for residents of Queens County, New York. Updated 2026-06-08.

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Queens County coverage highlights

Est. marketplace enrollees
3,573
2025 plan year — New York total 221,534 ÷ 62 counties.
Premium tax credit
100–400%+ FPL
Benchmark Silver premium capped at 0%–8.5% of household income. Sourcei
Medicaid expansion
Adopted
Adults up to 138% FPL eligible. Sourcei
CHIP (Child Health Plus)
405% FPL
Pregnancy Medicaid to 223% FPL. Sourcei
Carriers on marketplace
9
Statewide issuer count — county availability may vary. Sourcei
Medicare 5★ MA-PD (2026)
Not in county
No CMS 5-star MA-PD contract serves this county. Sourcei

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 Queens 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 Queens 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 Queens 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 Queens County

Residents of Queens County shop and enroll in ACA marketplace plans at nystateofhealth.ny.gov/. Plans are rated by county, so available carriers and prices in Queens 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 Queens 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 Queens County

Queens 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, 2026December 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

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.

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.