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NEED TO KNOW INFORMATION ON OBAMACARE FOR Residents of Manhattan New York City
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Please call JayMar Insurance Agency at 516-605-2757 for up to the minute information.
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 Manhattan that you might require in your newtork if you live in New York City.
Hospital For Special Surgery- If you live in the Manhattan and require specific orthopedic surgery at Hospital For Special Surgery your only carrier options are EmblemHealth, Empire Blue Cross Blue Shield, UnitedHealthcare all available on or off the New York Health Insurance Exchange AKA the New York State of Health.
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, 2017 there are currently no plans available to individuals that will include Memorial Sloan Kettering in their networks UNLESS you qualify for an Essential Plan, AND choose Emblem as your carrier.
NYU - Inpatient facilities in Manhattan include Tisch Hospital, Hospital for Joint Diseases, Hassenfield Children's Hospital, and Rusk Rehabilitation, and Bellevue Hospital Center Carriers that include NYU Langone Medical Center in their network are Empire and Emblem.
Mt. Sinai Beth Israel - Mt. Sinai has 7 hosptial campuses throughout the New York Metropolitan area. Manhattan campuses include Mt. Sinai Beth Israel on the Lower East Side, Mt. Sinai Hospital on the border between East Harlem and the Upper East Side, Mt. Sinai Roosevelt serving Midtown and the West side, and Mt. Sinai St. Luke's serving West Harlem and Morningside Heights Communities. Carriers that include Mt. Sinai/Beth Israel in their network include The EPOs (no referrals required) Oscar and Empire, as well as the modestly priced both are accepted at Mt. Sinai. Alteratively one could choose the costly HMO's such UnitedHealth Care, or EmblemHealth. United Healthcare however does not include Mt. Sinai's main campus in Manhattan.
NY Presbyterian/Columbia/Weill Cornell - NewYork-Presbyterian Hospital, based in Manhattan New York City, is one of the nation's largest and most comprehensive hospitals, and is touted as the #1 hospital in the New York metropolitan area. The carriers accepted by New York-Presbyterian are the affordable Health Plans, as well as the more expensive HMO's EmblemHealth, Empire, and UnitedHealth Care.
’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.
Tax credits, or subsidies, are only availablt to qualifying individuals and businesses on the Exchange.
Oscar Health Insurance (EPO) - Oscar Health Insurance of New York is a carrier that is becoming widely recognized for “Shaking up the industry”, in a really hip way. With more affordable options than most of its HMO competitors, Oscar may be the right carrier for you. Currently based in New York City, Oscar’s customer service is head and shoulders above the rest of its industry, while their entire focus revolves around making an incredible customer experience. Oscar's seamless technology including online claims management, Telemedicine, provider searches, and their unique customer service approach makes Oscar a pleasure to work with.
Each year Oscar’s rates have experienced some of the lowest increases year over year in the Marketplace.
Oscar also offers two incredible benefits that not too many others do. Many have been frustrated with the fact that plans available to individuals and families do not offer Out of State Coverage unless you have an emergency and go to an emergency room, but with every one of Oscar’s plans comes a national network of Urgent Care centers AND free telemedicine providing you with the ability to treat any condition from any state in the country.
Oscar Health Insurance have a strong yet lean network of over 20,000 providers as well as some of the best hospital systems available in New York State. In Manhattan Oscar insurance includes all facilities associated with Mt Sinai, Mt. Sinai Beth Israel, and NY Eye and Ear Infirmary of Mt Sinai.
Oscar's plans are a great value, with non-standard plan options that include flexible cost-sharing designs, free generic drugs, all with some of the lowest premiums among the carriers. These plans are available to Individuals ONLY (On/Off).
Empire Blue Cross/Blue Shield (EPO) - Empire Pathway Network is is Empire’s HMO network for individuals, families and small businesses in New York. Empire Blue Cross Blue Shiled of New York has a strong network throughout Manhattan but it will cost you. Empire does currently participate with most of the the major hospitals in Manhattan with the exception of Memorial Sloan Kettering. Empire Blue Cross Blue Shield had some of the largest premium increases every year as their rates increased nearly 25% each year, now making Empire the highest cost 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)
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 as broad as those of most of the other carriers, however it and includes many of the major hospitals in New York City. They have plans avaialable to individuals/families (On/Off) and small businesses (On/Off).
United Healthcare (HMO) - With a TWENTY EIGHT PERCENT rate increase this year 2017 has been a very difficult year for United Healthcare. Every year since inception United Healthcare has been the highest priced carrier, and this year is no exception. United Healthcare’s 2017 rates are ONE HUNDRED FIFTY percent higher than its competitors.
To add fire to the flame United Healthcare is canceling their individual and family insurance plans in 37 out of the 39 states they do business in, leaving New York State as one of the 2 that they are staying in, for now. 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. Important hospitals hat do not participate with United Healthcare include Memorial Sloan-Kettering, NYU Langone, New York Downtown Hospital, and Mt Sinai's main campus.
Because United Healthcare is available on-Exchange, premiums may be reduced for those who qualify for a subsidy. This carrier is available to Individuals and Families (On).
United Healthcare (ESSENTIAL PLANS) -
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 large with about 40,000 participating providers, and 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) - United Healthcare Oxford is canceling all of their plan offerings to individuals and families in the state of New York in 2017
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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