Available Insurance Options
HMO Participation in NY Health Insurance Programs

Available Insurance Options

New Yorkers that do not have health insurance can either:

• Apply for reduced-cost health insurance through New York State (eligibility requirements exist) or,
• Purchase coverage directly from an HMO (individual coverage).

The following table explains these options.

Apply for Programs Offered by New York State Purchase Insurance Coverage Program HealthyNY Child Health Plus Family Health Plus HMO plan or HMO/POS plan Who qualifies? Small employers, sole proprietors and working uninsured individuals. Children who are under 19 years of age and do not have other health insurance. Eligibility criteria was expanded in 2007, making this program available to more children. Adults between 19 and 64 years of age who are uninsured and whose incomes are too high to qualify for Medicaid. Uninsured adults and families who are not eligible for other coverage. Cost HealthyNY benefits are the same for each HMO, but monthly premiums will vary. Depending on your family's gross income, you may have to pay a monthly contribution to enroll in Child Health Plus. Families that insure a child through this program do not have to pay copayments to receive services. There is no cost to participate in Family Health Plus. There are no premiums or deductibles. Modest copayments apply to some services. You can purchase either of these benefit packages from HMOs operating in your area. See the HMO Participation in NY Health Insurance Programs to determine which HMOs operate in your area. Rates can be found at www.ins.state.ny.us/ ihmoindx.htm Enrollment Call this toll-free number: 866-HEALTHY-NY (866-432-5849), or visit the Web site at www.HealthyNY.com. Call this toll-free number: 800-698-4KIDS (800-698-4543) or visit the Website at http://www.health.state.ny.us/ nysdoh/chplus/index.htm Contact your local Social Services district office about Family Health Plus or visit the Web site at http://www.health.state.ny.us/ nysdoh/fhplus/index.htm Individuals may enroll in either an HMO or HMO/POS plan at any time and may not be denied coverage for health reasons There are special considerations if you have a pre-existing medical condition.

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HMO Participation in NY Health Insurance Programs

This table shows HMO participation in New York State programs for uninsured New Yorkers.

Click here for the pdf version of the table

HMO HealthyNY Child Health Plus Family Health Plus Aetna Health Inc. X     Atlantis Health Plan X     CDPHP X X X Community Blue (HealthNow) X X X Empire HealthChoice HMO, Inc. X X   Excellus Health Plan, Inc. (HMO) X X X GHI HMO Select, Inc. X X X Health Net of NY, Inc. X     HIP HMO X X X Independent Health Association, Inc. (IHA) X X X MVP Health Plan, Inc. X X X Oxford Health Plans of NY, Inc. X     Rochester Area HMO, Inc. (Preferred Care) X     UnitedHealthcare of NY   X X

Questions About Programs for the Uninsured?

HealthyNY: Health insurance program for small employers, sole proprietors and uninsured working individuals.
866-HEALTHYNY (866-432-5849)
www.HealthyNY.com

Child Health Plus: Health insurance program for children who are under 19 years of age.
800-698-4KIDS (800-698-4543)
http://www.health.state.ny.us/nysdoh/chplus/index.htm

Family Health Plus: Health insurance program for adults between 19 and 64 years of age who are uninsured but have incomes to high to qualify for Medicaid.
877-934-7587
http://www.health.state.ny.us/nysdoh/fhplus/index.htm