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

if you need help now call 516-605-2757






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 Queens that you might require in your newtork if you live in Queens. 















Nearly every carrier  includes both Flushing Hospital and Medical Center and Jamaica Hospital and Medical Center in their networks.









Mt. Sinai Beth Israel - Mt. Sinai has 7 hosptial campuses throughout the New York Metropolitan area.  Their Queens campus is Mt. Sinai Hospital of Queens.  (NOTE: Queens Hospital Center and Elmhurst Hospital Center are affiliated with Mt. Sinai School of Medicine, however this does NOT mean that all carriers that have Mt. Sinai/Beth Israel in their network also include Queens and Elmhurst Hospitals).  Carriers with Mt. Sinai/Beth Israel in their network include EmblemHealth, Oscar, Empire, and United Health Care










New York Presbyterian - NewYork-Presbyterian Hospital, based in New York City, is one of the nation's largest and most comprehensive hospitals. New York-Presbyterian is touted as the #1 hospital in the New York metropolitan area and is consistently ranked among the best academic medical institutions in the nation, according to U.S. News & World Report. The hospital has academic affiliations with two of the nation's leading medical colleges: Weill Cornell Medical College and Columbia University College of Physicians and Surgeons.  New York Hospital Queens and NewYork-Presbyterian have joined forces to improve access to state-of-the-art care for residents of Queens. New York Hospital Queens, a member of the NewYork-Presbyterian Healthcare System for more than 22 years, has been renamed NewYork-Presbyterian/Queens effective July 1, 2016.  If you need New York Hospital of Queens in your network you have acces with the following carriers:  EmblemHealth Empire, United Health Care and Oxford.  Oscar will no longer include NY Presbyterian or its affilited providers in their network as of March 31, 2016.













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 no plans available to individuals outside of medicaid products are available that give one access to Sloan. We urge you to raise your voice on this issue. Call your elected officials and see that something is done about this.










’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 Blue Cross/Blue Shield (EPO) - Empire Blue Cross/Blue Shield (EPO) - Empire Pathway Network is the network for individuals, families and small businesses. They have a very strong network and currently participate with all the the major hospitals in Queens. They had some of the largest premium increases in 2016, now making them among the highest in the Marketplace, however due their substantial network, many individuals may find them to be one of their best options. 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 however they do include 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) - United Healthcare’s Compass Network is the insurance company's Qualified Health Plan (QHP) network and is comprised of approximately 40,000 providers.  Most of the major hospitals in Queens accept the Compass plans.


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 that 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) - Individuals and families have access to Oxford off-Exchange HMO plans through thier new Metro network.  The major hospitals in New York City that accept the Metro plans are Hospital for Special Surgery, Mt. Sinai Health System, New York Presbyterian Health System and Memorial Sloan Kettering Cancer Center.  


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 Queens 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 most major hospitals in New York City and Queens. 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 516-605-2757 for help determining which plan and network is right for you.  Or see JayMar Insurance Agency for more information.






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