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Insurance Coverage

As a result of rules governing health insurance coverage implemented by the Affordable Care Act, and the launch of the New York State Health Exchange, there has been a great deal of confusion about which plans specific hospitals accept.

The following details all of the insurance products and plans which NYU Winthrop Hospital accepts. Please keep in mind that there is a difference between 'plan' and 'product'. People are sometimes confused when they select a certain insurance carrier and find out that a particular provider does not accept a specific product of that carrier or plan. NYU Winthrop will attempt to work with carriers on a case by case basis to negotiate payment for plans we don't participate with.

As of January 1, 2015, NYU Winthrop Hospital has contracts with the following managed care health plans. This list is updated periodically and subject to change. It may not be comprehensive.

Please check with your health plan to verify coverage. Please be advised that there may be certain services provided in our facility which are not covered by your plan. Please inquire with your health plan before calling to schedule an appointment.

Please note that your health plan may require you to obtain a referral from your primary care provider before being seen by our specialists.


Aetna

Aetna Medicare Plan (HMO)
Aetna Select
Elect Choice HMO
Managed Choice POS
Quality Point-of-Service (QPOS)
Aetna Medicare Plan (HMO) Open Access
Aetna Health Network Only
Aetna New York Signature
Aetna Open Access Elect Choice
Aetna Open Access HMO
Open Access Aetna Select
Aetna Choice POS
Aetna Choice POS II
Aetna Medicare Plan (PPO)
Aetna Health Network Option
Aetna Open Access Managed Choice
Aetna Limited Benefits Insurance Plan (PPO)
Open Choice PPO
Aetna Savings Plus
Aetna Voluntary Group Medical Plan (indemnity plan)
Traditional Choice


Affinity

Medicaid
Child Health Plus
Medicare Advantage
Affinity Essential Platinum
Affinity Essential Gold
Affinity Essential Silver
Affinity Essential Bronze
Affinity Essential Catastrophic
Affinity Essential American Indian


Agewell

Medicare Advantage


AlphaCare


AmeriChoice by UnitedHealthcare

Child Health Plus
Family Health Plus
Medicaid


Centers Plan For Health Living

FIDA Plan


CenterLight Healthcare

CenterLight Healthcare Direct Complete Plan HMO SNP
CenterLight Healthcare Total Plan HMO SNP
CenterLight Healthcare Select


CHN (Consumer Health Network)

PPO - CHN Client List


Choice Care

PPO


CIGNA Healthcare

GWH-Cigna
GWH-Cigna Open Access Plus
Global Health Benefits
Cigna Choice Fund Open Access Plus
Shared Administration PPO
Shared Administration OAP
Managed Care Plans: Network Open Access
Managed Care Plans: Open Access Plus
Managed Care Plans: HMO or POS Open Access
Managed Care Plans: LocalPlus
Managed Care Plans: Primary Care Physicians HMO or POS
Managed Care Plans: Primary Care Physicians Network PPO or EPO
Plans Strategic Alliance Indemnity


Coventry

Coventry / First Health - National PPO Network


Devon Health

National PPO
Regional PPO
Supplemental PPO Networks


Elderplan

Elderplan for Medicaid Beneficiaries HMO SNP
Elderplan Advantage for Nursing Home Residents HMO SNP
Elderplan Classic Zero Premium HMO
Elderplan Medicaid Advantage HMO SNP
Elderplan Extra Help HMO


Emblem Health / GHI

GHI City of NY Health Benefits Program
GHI EPO/PPO
GHI EPO/PPO HSA
GHI EPO/PPO Share
GHI Alliance 365 Day Hospital - Only
GHI Alliance Value Plan GHI Flex Select/EPO
Hospital Benefits PPO
GHI Network Access PPO
GHI Small Business Advantage Plan
HMO Plans
HMO Select
GHI Medicare Dual Eligible (PPO SNP)
GHI Medicare Choice PPO


Emblem Health / HIP

Family Health Plus
Family Health Plus R
HIP Access I & II Plans (VYTRA HMO)
HIP Choice Plus Direct Pay POS
HIP Classic Network HMO
HIP HMO Direct Pay
HIP PPO Self - Insured
HIP Premium Network EPO/PPO
HIP Premium Network HMO/POS
HIP Prime Child Health Plus
HIP KID HIP Prime Network EPO/PPO
HIP Prime Network HMO/POS
HIP Select EPO Plans
HIP Select PPO Plans
HIP SmartStart Network for EPO
HIP Medicaid
HIP Medicaid R
HIP VIP Medicare Access
HIP VIP Medicare Advantage


EmblemHealth

ConsumerDirect EPO
EmblemHealth CompreHealth HMO
EmblemHealth CompreHealth EPO
EmblemHealth EPO/PPO
InBalance EPO
Medicare Group Access (PPO)
Medicare Dual Eligilbe (PPO SNP)
Medicare VIP Essential (HMO)
Medicare VIP Premier (HMO) Group
Vytra / HIP HMO Access I & II Plans
Vytra / HMO
Vytra / SmartStart


Empire Blue Cross Blue Shield

HMO
Direct HMO
Direct POS
DirectShare POS
Direct Pay HMO
Direct Pay HMO/POS
Child Health Plus
Healthy New York
MediBlue HMO
MediBlue PPO
MediBlueSMSmartValue Plus PPO EPO
Empire Total Blue
Empire Prism EPO
Empire Prism PPO
Blue Priority

Fidelis Care

Child Health Plus
Family Health Plus
Medicaid
Fidelis Dual Advantage
Fidelis Dual Advantage Flex
Fidelis Medicare Advantage Flex Plan HMO-POS
Fidelis Medicare Advantage $0 Premium HMO Plan
Fidelis Medicare Advantage Without RX HMO-POS Plan


First Health

National PPO Network


Healthfirst

Family Health Plus


Health Plus

Medicaid
Child Health Plus
Medicaid Advantage
Medicaid Advantage Plus
Health Plus Medicare Advantage


Health Republic


HealthSmart

World Trade Center Program only


Humana

PPO


Island Group

Island Group PPO


Integra

FIDA Plan


MagnaCare

MagnaCare Client List ASO/PPO
MagnaCare Access
MagnaCare National Access
MagnaCare Preferred PPO
MagnaCare Standard PPO
MagnaCare - Guardian


National Preferred Provider Network (NPPN)

Insurance Carriers
Other Managed Care Organizations
Self - administered Employers
Taft - Hartley Plans
Third Party Administrators


Metracomp


Multiplan


National Provider Network (NPN)

National Provider Network


Oscar Insurance Company

Gold Edge Plan
Silver Edge Plan
Silver Edge+ Plan
Bronze Edge Plan
Bronze Edge+ Plan
Platinum Edge Plan
Gold Plan
Silver Plan
Bronze Plan
Platinum Plan
Secure/Catastrophic Plan


Oxford

Freedom Plan® PPO
Liberty PlanSM Gated EPO
Liberty PlanSM Gated PPO
Liberty PlanSM PPO
LibertySM HMO
Oxford® EPO (Freedom Network/Liberty Network)
Oxford® EPO HSA (Freedom Network/Liberty Network)
Oxford® PPO HSA (Freedom Network/Liberty Network)
Primary AdvantageSM (Liberty Network)
Oxford Platinum NY Standard PPO
Oxford Platinum NY Standard EPO
Oxford Gold NY Standard EPO
Oxford Silver NY Standard PPO
Oxford Silver NY Standard EPO
Oxford Bronze NY Standard EPO
AARP Medicare Complete HMO Plan i
AARP Medicare Complete HMO Plan 2i
AARP Medicare Complete Essential H
AARP Medicare Complete Plan I
AARP Mediare Complete Mosaic H


Quality Health Plans of NY

Medicare Advantage Silver NY
Medicare Advantage Platinum Plus NY


Senior Whole Health

Medicare Advantage


Three Rivers PPO


United Healthcare

UnitedHealthcare Catalyst
UnitedHealthcare Choice
UnitedHealthcare Choice Plus
UnitedHealthcare Options Non-Differential PPO
UnitedHealthcare Options PPO
UnitedHealthcare NY Platinum HMO
UnitedHealthcare NY Gold HMO
UnitedHealthcare NY Silver HMO
UnitedHealthcare NY Bronze HMO
UnitedHealthcare NY Catastrophic HMO
UnitedHealthcare Platinum Compass
UnitedHealthcare Gold Compass
UnitedHealthcare Silver Compass
UnitedHealthcare Bronze Compass
UnitedHealthcare Catastrophic Compass
United Healthcare Medicare Complete Choice
United Healthcare Medicare Complete Choice Essential
AARP Medicare Complete HMO Plan i
AARP Medicare Complete HMO Plan 2i
AARP Medicare Complete Essential H
AARP Medicare Complete Plan I
AARP Medicare Complete Mosaic H
UnitedHealthcare Community Plan
Child Health Plus
All Products except: Medicare Advantage Regional PPO
Workers Compensation
No fault
United Core Benefit Plans
United Charter Benefit Plans


USA


US Family Health Plan

Tricare Prime Program PPO


VNS Choice

VNS Choice - Managed Long Term Care Plus
(MLTC Plus)
VNS Choice Medicare - Option Plans


Wellcare

Medicare Advantage