Start your CoveredNYC intake

Tell us what kind of New York health coverage help you need.

This signup flow is built for real users: individuals, families, self-employed workers, small businesses, U.S. citizens, immigrants, and mixed households anywhere in New York State. It creates a broker review record and shows what happens next.

Licensed broker review queueNot NY State of Health or the governmentServing all New York StateNo official eligibility decision here

Coverage help signup

Full name Email Phone County, borough, or region

What kind of help do you need? Tell us briefly what is going on

Preferred contact method Preferred contact time Preferred language Deadline or coverage end date

Already have a current plan?

Optional: add enough information for a broker-ready comparison. You can also use the dedicated Compare Plan page.

Current carrier / plan Monthly premium Deductible Out-of-pocket max

I have a notice, renewal letter, request for documents, bill, denial, termination, or marketplace message. I agree that CoveredNYC may contact me about my request. I understand CoveredNYC is not NY State of Health or the government and this form does not enroll me or make an official eligibility decision.

Emergency note: Do not use this form for medical emergencies. Call 911 or go to an emergency room for emergencies. Do not upload unnecessary medical records or full medical history.