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Winthrop University Hospital

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 Winthrop-University 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. 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, Winthrop University 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 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


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


Medicare Advantage


AmeriChoice by UnitedHealthcare

Child Health Plus Family Health Plus Medicaid

Centers Plan For Health Living


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


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 / First Health - National PPO Network

Devon Health

National PPO Regional PPO Supplemental PPO Networks


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 Eligile (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


ConsumerDirect EPO EmblemHealth CompreHealth HMO EmblemHealth CompreHealth EPO EmblemHealth EPO/PPO InBalance EPO Medicare Group Access (PPO) Medicare Dual Eligile (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


Family Health Plus

Health Plus

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

Health Republic


World Trade Center Program only



Island Group

Island Group PPO




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



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


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 Mediare 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


US Family Health Plan

Tricare Prime Program PPO

VNS Choice

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


Medicare Advantage
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Winthrop-University Hospital
259 First Street | Mineola NY 11501 | 516-663-0333

This site provides information as a resource. It is not a substitute for professional medical advice.
Always consult a physician or healthcare provider for treatment and guidance toward good health.
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