NEED TO KNOW INFORMATION FOR Residents of Bronx New York City on obamacare

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Please call JayMar Insurance Agency at 516-605-2757 for up to the minute information. If you or your organization would like JayMar to come in to present a free seminar please let us know, we would like to hear from you.  For more information on our Free Obamacare Seminars For NYC Residents See Our Page On NYC Obamacare Seminars.


Most folks assume that if their hospital or doctor took their insurance before that they will continue to with their new policy, but this is not always the case.   Below are a few of the major hospitals in the Bronx that you might require in your newtork if you live in the Bronx. 










Montefiore Medical Center - Has several locations in the Bronx.  The Moses Campus located in the Norwood section of the Bronx includes the Children's Hospital of Montefiore and Greene Medical Arts Pavilion.  The Einstein Campus located in the Pelham Parkway section of the Bronx, next to Albert Einstein College of Medicine, includes Weiler Hospital and Montefiore Medical Park.  The Wakefield campus, adjacent to the Bronx River Parkway, includes the Wakefiled Hospital, the Carpenter Avenue Medical Pavilion and the Wakefield Ambulatory Center.  The Westchester Square Campus has a full-service emergency room department, an ambulatory surgery center and primary and specialty care.  The Hutchinson campus, off the Hutchinson River Parkway is located in the Pelham Bay section of the Bronx and includes the Center for Orthopedic Specialities among other specialties. If you live in the Bronx no matter what carrier you choose, they are most likely to have Montefiore in their network.  Montefiore accepts EmblemHealth, Oscar, Empire, United Healthcare.








Bronx-Lebanon Hosptial Center - is the largest voluntary, not-for-profit health care system serving the South and Central Bronx and is now among the largest providers of outpatient services in New York City. Most carriers include Bronx-Lebanon Hospital Center in their network with the exception of EmblemHealth.







St. Barnabas Hospital - is a not-for-profit, nonsectarian, acute care community hospital and Level I Trauma Center authorized to treat the most critically ill and severely injured patients. Their health care network provides high-quality inpatient, outpatient and emergency medical, mental health and dental services throughout the Bronx.  St. Barnabas accepts most carriers, with the exception of Empire and EmblemHelth.










Memorial Sloan Kettering Cancer Center - New New York City has the highest incidences of cancer in the country, and if you or someone in your family currently has cancer or a history of cancer you may need Memorial Sloan Kettering in your network. Memorial Sloan Kettering Cancer Center is a cancer treatment and research institution founded in 1884 as "the New York Cancer Hospital."  Their main campus is located in Manhattan New York City. 


As of January 1, 2016 there are currently no plans on the Exchange that will include Memorial Sloan Kettering in their networks. Individuals who need Memorial Sloan Kettering in their network can enroll in Oxford's Metro Network, available off-Exchange only.  As we learn new information we will be updating this regularly.











’On’ indicates that these plans are available in the Individual Marketplace or the SHOP Exchange (for Small Business).


‘Off’ indicates the plan is available through a broker, and does not qualify for any premium credits.


If a plan is not available on the New York State of Health Exchange you will not be elegible for an Advanced Premium Tax Credit (individual/family) or Small Business Tax Credits if you choose one of those plans.




Empire Blue Cross/Blue Shield (EPO) - Empire Pathway Network is their network for individuals, families and small businesses offered both on and off the Exchange.  The hospitals in the Bronx that accept this plan are Bronx-Lebanon Hospital Center, Montefiore Medical Center, and Calvary Hospital of the Bronx.  They had some of the largest premium increases in 2016, now making them among the highest in the Marketplace.  Qualifying individuals and families who apply on-Exchange can get subsidies to reduce their premiums. Plans are available to individuals and families (On/Off), or Small Business plans (Off).  ​  





EmblemHealth (HMO) - SelectCare is the name of the network offered by EmblemHealth to individuals families as well as small businesses. With only about 12,000 participating doctors and health care providers in New York, their network is not nearly as broad as most of the other carriers but does include many of the major hospitals in New York City.  The only major hospital in the Bronx that accepts Emblem is Montefiore Health System.  They have plans avaialable to individuals/families (On/Off) and small businesses (On/Off).  










United Healthcare (HMO) - United Healthcare’s Compass Network is the insurance company's Qualified Health Plan (QHP) network and is comprised of approximately 40,000 providers.  While many of the major hospitals in Manhattan accept the Compass plan, some hosiptals have left the network in 2016.  Hospitals that do not participate include Memorial Sloan-Kettering, NYU Langone, New York Downtown Hospital, and Mt Sinai's main campus.


Premiums are approximately 30% higher than average, making them among the highest of the carriers.  Because they are available on-Exchange, premiums may be reduced for those who qualify for a subsidy.  This carrier is available to Individuals and Families (On).


In 2016 the New York State of Health is offering new, highly affordable plans to low income individuals called "Essential Plans."  UnitedHealth Care's Essential Plan is provided through their Community Plan Network, and qualifying individuals can choose a plan which offers medical coverage only, or they can upgrade their plan to include vision and dental coverage for a minimal increase in premium.  Their provider network is somewhat limited compared to those of QHPS, however they include most major hospitals in New York.


Depending on income and family size, the cost for these plans is either $20 per month per person (for medical only) with no deductibles and small copays for services; or they are completely free with no premium, deductibles or copys.  Qualifying individuals may enroll in Essential Plans all year long.  Call JayMar Insurance to see if you qualify.








Oxford (HMO) - Small businesses have access to HMOs, EPOs and PPOs off-Exchange through both Liberty and Freedom networks. These networks include all the major hospitals in New York City in New York City.   Metro accepts all hospitals in the Montefiore Health System.


Small businesses have access to HMOs, EPOs and PPOs off-Exchange through both Liberty and Freedom networks. These networks include all the major hospitals in New York City, and many doctors in Manhattan participate in their network.  Metro's premiums are substantially less in 2016 than they were for individuals in the Liberty Network in 2015, however this new network is smaller and has fewer hospitals that participate with their plans.   For small businesses, premiums are still at least 30% higher than that of the other carriers.  Plans are available to Individuals (Off) and Small Business (Off).



Aetna - Aetna offers great plans to businesses off the Exchange.  Their premiums are higher than the average carrier, but their network is substantial with nearly 40,000 providers in New York.  Aetna includes most hospitals in New York city and the Bronx in their Network.  These plans are only available to a Small Business (Off).






Oscar Health Insurance - Oscar is a new carrier that was established to sell coverage on or off the New York State of Health Exchange Marketplace.  They have a network of over 30,000 providers and 80 hospitals, and 139 urgent care clinics across New York State. Ther network includes many of the major hospitals in New York City and the Bronx.  NewYork-Presbyterian Hospitals and their affiliated physicians will be in-network until March 31, 2016.


Oscar's plans are a great value, with non-standard options that include flexible cost-sharing designs and with some of the lowest premiums among the carriers. These plans are available to Individuals ONLY (On/Off). 







Please contact JayMar Insurance Agency at 631-875-2993 for help determining which plan and network is right for you.  Or see JayMar Insurance Agency for more information.


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