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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 September 2019, 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 facilitity 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 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 Voluntary Group Medical Plan (indemnity plan)
Traditional Choice
*NYU Winthrop is not participating with Aetna NAP or Aetna Premier Network

Agewell

Medicare Advantage
FIDA Plan

AlphaCare

CenterLight Healthcare

All Products

Choice Care / Humana

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

Elderplan

All Products

Emblem Health / GHI

GHI City of NY Health Benefits Program (Comprehensive Benefits Plan CBP)
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 Small Business Advantage Plan
HMO Plans
GHI Medicare Dual Eligible (PPO SNP)
GHI Medicare Choice PPO

Emblem Health / HIP

Essential Plans
HARP (Health and Recovery Plan)
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 (NYU Winthrop is not par with products on the Select Network)

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
MediBlue HMO
MediBlue PPO
MediBlueSMSmartValue Plus
PPO
EPO
Exchange Pathway, Pathway X and Pathway X Enhanced
Empire Total Blue
Empire Prism EPO
Empire Prism PPO
Blue Priority

Fidelis Care

Child 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
Fidelis Essential Plans
Fidelis Harp

First Health

National PPO Network

Healthfirst

Child Health Plus B
EPO
Essential Plans
Exchange Plans
Medicaid
Medicare
FIDA Plans
Life Improvement Plan (HMO SNP)

Empire BCBS Health Plus (formerly HealthPlus Amerigroup)

Medicaid
Child Health Plus
Essential Plans
Medicaid Advantage
Medicaid Advantage Plus

HealthSmart

World Trade Center Program only

Humana

PPO (Choice Care Network only)
Medicare

Integra

FIDA Plan

MagnaCare

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

Metracomp (Workers Compensation)

Multiplan

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
All Products

Partners Health Plan

Medicare Medicaid/Dual Eligible

Senior Whole Health

Medicare Advantage

Three Rivers PPO

United Healthcare

HMO, POS, EPO, PPO, Medicare, Core, Charter, Compass

USA

US Family Health Plan

VNS Choice

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

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