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Empire Blue Cross Healthy NY

Oct 14th, 2011

Empire Blue CrossEmpire Blue Cross and Blue Shield is an independent licensee of Blue Cross and Blue Shield which is a major health plan association. They have about 5 million members in New York and across the US. The Blue Cross and Blue Shield Association has been in existence for 80 years and have grown to 39 independent companies bringing the Blue Cross and Blue Shield health insurance products to residents from various states.

They have eight regional offices in New York: Albany, Bohemia, Melville, Middletown, Poughkeepsie, Syracuse, and Yorktown Heights and New York.

Empire Blue Cross and Blue Shield offers these health insurance plans:

  • Child Health Plus
  • Healthy NY
  • Direct Pay HMO and Direct Pay HMO/POS
  • TraditionPLUS Hospital

Child Health Plus is a state subsidized health insurance program that provides coverage to children under the age of 19. There are eligibility requirements particularly an income limit to qualify.

Empire Blue Cross Healthy NY on the other hand is also a state subsidized health insurance program for adult residents. They provide coverage to individuals, sole proprietors and small business (with less than 50 employees) owners who want to provide coverage to their employees. Eligibility requirements also apply. Aside from the income limit, applicants need to qualify for the following:

  • you must be a NY state resident
  • you should have no health insurance for the past 12 months unless if the reason for application is due to qualifying events such as:
    • death of a family member especially if it was the principal holder of the policy
    • loss of employment which is the source of your health and insurance coverage
    • transferring to a new job
    • moving to a new house/residence
    • losing coverage through a group plan
    • losing your coverage through legal separation, divorce or annulment
    • losing your coverage from other public health care programs
    • cancellation or termination of COBRA coverage
  • you should not be eligible for Medicare; This program is available to adults below the age of 65
  • If employed, you must have no health care benefits from your employer
  • you or your spouse should be self employed or employed within the past 12 months

The benefits that  Empire Blue Cross Healthy NY have are the following:

  • emergency care (excluding ambulance)
  • inpatient care
  • outpatient care
  • inpatient and outpatient surgery
  • home health care
  • doctor visits
  • preventive care
  • x-ray and laboratory services

Healthy NY benefits are streamlined regardless of the insurance provider you choose.

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