|m34# |nd)|`lF5U|{h#?82 #C?$cqYPlYoLeIP8u?tlzB2Sv>Rx#y>b Z=cT?Xaocz'y_~S;]Xn$Y#Tp'}[6!t This encourages New Yorkers to seek medical attention from their homes rather than visit a hospital or doctor's office ultimately reducing strain on the healthcare system and preventing further spread of the virus. What benefits will my NY health insurance policy cover? The Empire Plan is the primary health benefits plan for NYSHIP, covering nearly 1.1 million members. Is financial assistance available under the ARP? 0000006649 00000 n Individual and Small Group Coverage. 0000028277 00000 n What if there isnt an in-network provider who can treat me? PDF NYSHIP RATES & DEADLINES FOR 2023 - upstate.edu p JxfID04!9x\0Rx(0|J OY NF1101 2022 NYSHIP Plan Comparison Healthcare Provider Administrative Guides and Manuals The following links provide information including, but not limited to, prior authorization, processing claims, protocol, contact information and resources. 3V7 |F B endstream endobj 11 0 obj <> endobj 12 0 obj <> endobj 13 0 obj <>stream 0000000916 00000 n Up to $600 per plan year for going to the gym, taking paid digital classes, or for youth sports fees. Many insurance policies cover a 90-day supply of prescription drugs if you use their mail order pharmacy. Effective 01/01/2020 the following employee groups will have a $25 office visit co-pay: . for 2023 by December 30, 2022 The annual Option Transfer Period is here. Will I be notified by my employer about continuing my health insurance if I lose my job? The HCSA, which helps state employees pay for health-related expenses with tax-free dollars, will now allow up to $550 of remaining balances from your 2021 HCSA to go toward eligible expenses incurred during the 2022 calendar year. Learn more about the protections for surprise bills. You are only responsible for your in-network copayment, coinsurance, or deductible. New York State Employees Health Benefits - CDPHP You may have to pay your copayment, coinsurance, or deductible for any in-person follow-up care or treatment. Its a surprise bill if an out-of-network provider treats you and an in-network provider was not available, or you had unforeseen services, or you didnt know the provider was out-of-network. Can I still continue my group health insurance? I have health insurance through my employer. Individual Coverage and Tax Credits.& You and your family have many health insurance options available through NY State of Health: The Official Health Plan Marketplace. Empire Plan General Information Book You can redeem your reward code (s) at a wide range of participating partners, including Amazon, Nike, Target and more. APSU Empire BlueCross BlueShield and Mount Sinai Health System - New York Medicare-primary enrollees or dependents should refer to the Empire Plan Medicare Rx Evidence of Coverage for prescription copayment amounts. The Department of Financial Services issued guidance on the ways you may receive telehealth services. If you are experiencing symptoms, if possible, you should call ahead to your health care provider or local health department before seeking treatment in person. Your health plan must cover eight tests per month for each individual covered by your plan. 0000003871 00000 n If your employer went out of business, you will not be able to get COBRA or continuation coverage. Check out our available positions. This notification list may be modified. You will not have to pay your copayment, coinsurance, or deductible when you go to your doctor, a provider at another outpatient setting, an urgent care center, or an emergency room to diagnose COVID-19, including when the services are provided through telehealth. What happens if I lose my health insurance when I am sick? Providers can visit the HRSA website for more information about this program. Medicaid, Essential Plan, and Child Health Plus. Will my health insurance cover telehealth services? 0000001372 00000 n You may not be enrolled in an HMO outside your area. Access to Out-of-Network Provider. If your insurer upholds a denial of coverage for treatment, you have the right to appeal to the Department of Financial Services. You are covered for medically necessary emergency services in hospitals. 0000001139 00000 n 0000001530 00000 n What if I want more than a 30-day supply of my prescription? 0000005145 00000 n If you need documentation of your need to isolate for school or work, you can fill out an Affirmation of Isolation Form instead of getting an Order of Isolation from the state or county Department of Health. 0000017166 00000 n Where can I get more information on the amount of premium assistance available to me under the ARP? You also have the right to buy individual coverage through the insurer that provided your group coverage, known as a conversion policy. Serving New Yorkers for more than 85 years, Empire BlueCross BlueShield (Empire) is on a mission to materially and measurably improve the health of New Yorkers. PIA( NYS Police Investigative Unit) COBRA or continuation coverage is only available if your employer keeps the group policy after you lose your job. The first set reflects 2023 biweekly rates for CSEA-represented employees who are Grade 9 and below. 0000008973 00000 n If you go to an emergency room at an out-of-network hospital, your insurer is required to cover your care until you are stabilized, and after that, you may need to transfer to an in-network hospital for the rest of your care. If I am covered as a dependent under my spouses/parents health insurance, do I have any rights to continue the coverage if they lose coverage? You and your family*** can receive up to $30 in reward dollars per plan year for completion of various programs and activities focused on improving health and wellness. 1-877-7-NYSHIP, press option 3 for the mental health/ substance use program, you will receive another set of . The Empire Plan pays for covered hospital services, physicians' bills, prescription drugs and other covered medical expenses. If your employer bought your policy in another state, contact your employer because the protections described below might not apply. A: Most County employees choose to enroll in the "Empire Plan" offered thru NYSHIP. 2022 State NYSHIP Enrollee Biweekly Premium Contributions . The NYSHIP Plan is the standard coverage for all employees. Insurers cant deny COVID-19 treatment as not medically necessary. You can use the same login details here. 0000002098 00000 n Do the telemedicine requirements for No-Fault automobile insurance apply to existing claims or only new claims? Because of a loss of income, New Yorkers may also be eligible for Medicaid, the Essential Plan, subsidized Qualified Health Plans or Child Health Plus. 0000004405 00000 n Yes, the Workers Compensation Board adopted Emergency Adoption of Amendments to 12 NYCRR 325-1.8, 329-1.3, 329-4.2, 333.2, and 348.2 (Telemedicine)to allow telemedicine in some circumstances for social distancing purposes due to COVID-19. If you are totally disabled on the date your individual health insurance policy terminates, your insurer will continue to pay for covered services for up to 12 months, or until you are no longer disabled, if sooner. >I,q%/0kYz[ad.-5-w6OB;n?/F:1R! 0000035149 00000 n Wx endstream endobj 99 0 obj <>stream If you have a question, call 1-877-7-NYSHIP (1-877-769-7447) toll free and select the appropriate program from the menu. 520 32 Patients fear losing care access ahead of changes to NYSHIP Empire Call 1-877-7-NYSHIP (1-877-769-7447) and follow the prompts to notify the appropriate program carrier/vendor as outlined below, . 2023 Empire Plan and NYSHIP Rates for State Employees Medicare. Health plans must cover tests you purchase in person or online. The Empire Plan 001 $50.89 $4.59 $219.75 $20.14 Blue Choice 066 $42.58 $0.21 $182.57 . NYSHIP Online contains health plan information for State and Local Government active enrollees. Employers that provide group health insurance coverage must offer employees (and their dependents) who lose coverage because of a loss of employment, loss of eligibility for coverage, or reduction in hours the right to continue the coverage under the employers health plan. PDF 2022 State NYSHIP Enrollee Biweekly Premium Contributions - CSEA, AFSCME Some list the Empire Plan name and/or carriers involved in coverage; others do not. Individual Coverage. 0000003307 00000 n Need More Information? $0 cost-share for primary care visits for children 18 and younger. 0000007764 00000 n Please visit the Department of Financial Services resource page for information on continuing your health insurance. If you are unable to resolve the issue after contacting your insurer, file a complaint with DFS. 0000004520 00000 n | Albany, New York 12206, 2023 New York HMO Benefit Summary Rx Plans, 2022 - 2023 Benefit Changes for HMO plans, 2022 - 2023 Benefit Changes for HMO Rx Plans, 2023 Summary of Benefits and Coverage Rx Plans, 2022 New York HMO Benefit Summary Rx Plans, 2021 - 2022 Benefit Changes for HMO plans, 2021 - 2022 Benefit Changes for HMO Rx Plans, 2022 Summary of Benefits and Coverage Rx Plans. COVID-19 vaccines are covered by Medicaid, Essential Plan, and Child Health Plus. If your employer bought your policy in another state, contact your employer for details. medically necessary. PDF Nys Health Insurance Plan/Employee Benefits Management Q: What are my health insurance choices?