What’s the difference between the Empire plan and the Excelsior plan?

“What is the difference between The Excelsior Plan and The Empire Plan?” The Excelsior Plan is a more affordable alternative to The Empire Plan. It offers many of the same features and benefits of The Empire Plan, with a higher degree of cost sharing between the employer and plan participants.

What is covered by Empire plan Nyship?

A. The Empire Plan is NYSHIP’s unique health insurance plan designed exclusively for New York State’s public employees and employers. The Empire Plan pays for covered hospital services, physicians’ bills, prescription drugs and other covered medical expenses.

Does NY Empire plan cover acupuncture?

About the Program Civil Service contracts with UnitedHealthcare Insurance Company of New York (United) to administer the medical/surgical portion of the Empire Plan and process and pay claims submitted by health care providers. Medical/surgical benefits cover a range of services, including acupuncture.

Does the Empire plan have a deductible?

Refer to your Empire Plan Medicare Rx documents for information about your out-of-pocket expenses. The combined annual deductible is $1,250 for the enrollee, $1,250 for the enrolled spouse/domestic partner and $1,250 for all dependent children combined.

Is the Empire plan the same as Empire BlueCross Blueshield?

Empire BlueCross is an HMO DSNP plan with a Medicare contract and a coordination of benefits agreement with the New York State Department of Health. Empire BlueCross (Empire) is the trade name of Empire HealthChoice Assurance, Inc. and Empire BlueCross HMO is the trade name of Empire HealthChoice HMO, Inc.

Who is the carrier of the Empire plan?

CVS Caremark administers The Empire Plan Prescription Drug Program for retail pharmacy network and mail pharmacy services.

Is Nyship a PPO or HMO?

SUNY participates in the New York State Health Insurance Program (NYSHIP). This program offers a PPO, known as the Empire Plan, and several different HMOs, varying by geographic region around the State. Specific coverage provisions and plan design vary by health insurance plan and by employee bargaining unit.

Does Empire Plan pay Medicare deductible?

The Empire Plan pays for much of the Medicare Part A and B deductible and coinsurance amounts if you use The Empire Plan provider network, and may pay for some other medical expenses not paid by Medicare.

Is acupuncture covered by Nyship insurance?

(NEW YORK STATE HEALTH INSURANCE PLAN “NYSHIP”) The Empire Plan covers acupuncture treatment at 100% after a $20 co-pay. There are no visit limits for this plan.

Does the Empire Plan cover wigs?

Coverage Limitations and Exclusions Coverage is subject to any dollar or frequency limits specified in the member’s specific benefit plan documents. Coverage for wigs/scalp hair prosthesis is excluded unless specifically listed as a covered health care service.

Does Nyship cover shingles vaccine?

The Department of Civil Service’s Employee Benefits Division (EBD) has advised RPEA that all NYSHIP plans currently cover Shingrix. The Empire Plan covers the vaccine at no copay from a participating provider’s office or a participating pharmacy.

Is Nyship private insurance?

Now, more than 55 years later, NYSHIP is one of the largest public employer health insurance programs in the nation, protecting over 1.2 million State and local government employees, retirees and their families. Over 800 local government employers offer NYSHIP.

Does Empire plan cover out of country?

Empire Plan coverage is available worldwide and not just for emergencies.

Is EmblemHealth and Empire the same?

EmblemHealth Services Company, LLC provides administrative services to EmblemHealth companies. The EmblemHealth companies are separate companies from Empire BlueCross BlueShield.

Can you use Empire BlueCross BlueShield out of state?

Most Blue Cross Blue Shield members can rest easy since Blue Cross Blue Shield coverage opens doors in all 50 states and is accepted by over 90 percent of doctors and specialists. And if your extended travel plans take you abroad, you can ensure you have access to quality care through GeoBlue.

Does Empire EPO require referral?

With Empire’s EPO (Exclusive Provider Organization) plan, you have access to an extensive network of doctors and hospitals across the country. So chances are your doctor is in our network. You don’t need to pick a Primary Care Physician (PCP), and you don’t need a referral to see a specialist.

What lab does Empire plan use?

Effective January 1, 2019, Quest Diagnostics will be joining The Empire Plan as an in-network laboratory provider. Quest has 6,000 in-network patient locations nationwide. LabCorp will also remain an in-network option.

Is Empire part of United Healthcare?

The Empire Plan members have nationwide network access, starting Jan. 1, 2021. Starting Jan. 1, 2021, members of The Empire Plan will have in-network access to the UnitedHealthcare Options preferred provider organization (PPO) network for all states and U.S. territories outside of New York.

Is Nyship a UnitedHealthcare?

Your SEHP medical coverage will be through insurance carriers under contract with NYSHIP: Empire Blue Cross Blue Shield (for hospital benefits), UnitedHealthcare Insurance Company of New York (medical/surgical), GHI/ValueOptions (mental health and substance abuse) and CIGNA/Express Scripts (prescription drugs).

Does Nyship cover out of state?

Benefits are available worldwide for covered, medically necessary services. The Empire Plan Participating Provider Program offers a network of over 300,000 physicians, laboratories and other providers located throughout New York and in many other states.

Does Nyship cover ambulance?

Licensed Ambulance Service No copayment when transported to a facility for medically necessary mental health or substance use care. $70 copayment when transported to a facility for medically necessary mental health or substance use care.

Is the Empire plan Accepted in Florida?

The Empire Plan offers an expanded physician network in Arizona, Connecticut, Florida, Maryland, New Jersey, North Carolina, Pennsylvania, South Carolina, Virginia,Washington D.C., West Virginia and the greater Chicago area.

What is the Medicare deductible for 2022?

The 2022 Medicare deductible for Part B is $233. This reflects an increase of $30 from the deductible of $203 in 2021. Once the Part B deductible has been paid, Medicare generally pays 80% of the approved cost of care for services under Part B.

Do NYS retirees get reimbursed for Medicare?

If you retired from a New York State agency and enrolled in a health insurance plan through the New York State Health Insurance Program (NYSHIP), you are reimbursed for the usual cost of the Medicare Part B (medical insurance) premium through your retirement benefit, unless you receive reimbursement from another source …

Can I get reimbursed for my Medicare Part B premium?

You may be reimbursed the full premium amount, or it may only be a partial amount. In most cases, you must complete a Part B reimbursement program application and include a copy of your Medicare card or Part B premium information.

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