Proposed Health Plan: Finding Your Provider!

How do I find out whether my health care providers are “in network” under the college’s proposed new plan?

Besides being more costly to enrollees, the College’s proposed new health care plan is more complicated than POMCO. Some of the complications stem from the fact that each portion or “program” within the overall plan has a different administrator.

The overall plan is called NYSHIP (New York State Health Insurance Program), but the medical/surgical program is administered through Empire United Health Care.

Since costs of treatment will be less if provided by practitioners “in network,” you will probably want to determine whether your current health care providers and their affiliated medical groups, laboratories, etc., participate in Empire United Health Care. This is the best name to use when calling your doctor’s office to verify his/her participation in the Empire Plan network.

The link to search for participating healthcare providers, hospitals, etc. is http://www.empireplanproviders.com/

While we cannot fully verify the accuracy of the provider directory, we have not yet heard of anything that suggests otherwise.

For information about NYSHIP Empire Plan’s different program components and their administrators,  you will find this link helpful:

https://www.cs.ny.gov/employee-benefits/pa-market/shared/providers/index.cfm

In brief, the component programs and administrators are:

medical Medical/Surgical: Empire United Health Care

hospital Hospitals: Empire Blue Cross/Blue Shield

mental_health Mental Health / Substance Abuse: Beacon Health Options

pharmacy Prescription Drugs: CVS/Caremark