NEED TO KNOW INFORMATION FOR ResidentS of Staten island New York City on obamacare

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Please call JayMar Insurance Agency at 631-875-2993 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 the major hospitals in Staten Island that you might require in your newtork if you live in Staten Island. 







Staten Island University Hospital - North Shore LIJ Health System is ranked among the nation's top 50 hospital systems. Staten Island University is Part NSLIJ Health System.  The hospital has two locations in Staten Island: the North Site is located at 475 Seaview Avenue and the South Site is located at 375 Seguine Avenue.  Staten Island University Hospital accepts most carriers, however it does not accept Health Republic as no hospitals in the NSLIJ Health System accept Health Republic at this time.  NSLIJ CareConnect, Oscar, Empire, United Healthcare and Oxford all have Staten Island University Hospital in their networks. 








Richmond University Medical Center - an affiliate of Mt. Sinai University Hospital and the Ichan School of Medicine, Richmond University is Staten Island's other major hosptial  providing acute, medical and surgical care 

including emergency care, surgery, minimally invasive laparoscopic and robotic surgery, gastroenterology, cardiology, pediatrics, podiatry, endocrinology, urology, oncology, orthopedics, neonatal intensive care and maternal health. It is a Level 1 Trauma Center and a designated Stroke Center, maintains a Wound Care/Hyperbaric Center and a Sleep Disorder Center on-site at its main campus.  The hospital also offers behavioral health services, encompassing both inpatient and outpatient services for children, adolescents and adults, including emergent inpatient and mobile outreach units.  It is the only borough facility that offers inpatient psychiatric services for adolescents.  Its main campus is located at 355 Bard Avenue in Staten Island; the Bayley Seton campus is at 75 Vanderbilt Avenue and is primarily a psychiatric and social services outpatient hospital.  Most carriers have Richmond University Medical Center in their networks.











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 (HMO) - Empire Pathway Network is their network for individuals, families and small businesses offered both on and off the Exchange.  The plan is accepted by most New York City hospitals, including Richmond University Medical Center.  Staten Island University Medical Center is no longer in Empire's network.   


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).  ​




NSLIJ CareConnect (EPO) - was created by North Shore-LIJ Health System in 2013 to "ensure that its community has affordable access to excellent care.” They offer non-standard plans with alternative cost-sharing options at very affordable premiums. Their network is primarily comprised of NSLIJ hospitals and providers, but also includes Lenox Hill Hospital, Maimonides Medical Center and Montefiore Health System. Staten Island University Hospital is a NSLIJ hospital.  For 2016, CareConnect is offering small and large groups the option of a national wrap network.  Along with its quality network and reasonable costs, CareConnect offers the unique feature of integrated medical management. Plans are available to individuals and families (On/Off) and small and large businesses.








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 those of most of the other carriers abut does include many of the major hospitals in New York City.  Emblem has Staten Island University Hospital in its network, but does not include Richmond University Medical Center.  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  - Individuals and families have access to Oxford off-Exchange HMO plans through thier new Metro network.  Small businesses have access to HMOs, EPOs and PPOs off-Exchange through both Liberty and Freedom networks. These networks include most major hospitals in New York City, however the Metro Network does not participate with either of Staten Island's major hospitals.


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).









Affinity Health Plan (HMO) - Affinity offers both Qualified Health Plans through their Access Network and Essential Plans: new plans offered in 2016 for low imcome individuals which cost either $20 a month or are free, depending on your income and family size.  Affinity has a network of over 30,000 providers, includes most major hospitals in New York City inlcuding both of Staten Island's major hospitals, and offers some of the lowest priced plans available.  Plans are avaible to individuals and families (on/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 Staten Island.  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. Their network includes most major hospitals in New York City and includes both of Staten Island's major hospitals. 


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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