HIP Healthy NY

Credit: Kenny Louie via Flickr under Creative Commons

Health Insurance Plan of New York or better known as HIP began in 1940 as a group organization offering prepaid health insurance plans to residents of New York.  After fifty-five years, they have grown to be among the top health insurance providers in the state of New York and the largest Health Maintenance Organization. Today, more than 1.4 million New Yorkers trust HIP for their health insurance needs.  They have more than 22,000 contracted physicians in their network.

As proof of HIP’s innovation, they were the first one to have a website in various languages.

In HIP you can find a wide range of health coverage products.  They not only offer traditional health insurance plans but alternative and unconventional medicine program as well like yoga, acupuncture, LASIK and discounts for health clubs.

HIP also offers Healthy NY – a state-subsidized health insurance program created to address the state’s problem with the increasing rate of the uninsured. This program is available to individuals who are self-employed or employed.

Since it’s government-subsidized, there are eligibility requirements for Healthy NY application such as:

• You can only apply if you are currently residing in New York
• You should not be eligible to apply for Medicare
• Your total annual household income should be within the program’s limit
• You should be currently working either as an employee or a self-employed individual and
• Only if there are no health care benefits being offered there
• You should be without any health insurance coverage for the past 12 months unless you lose your coverage because of any of these reasons:

1.       You are about to lose your job

2.       You are transferring to a new job

3.       When the plan-holder in your family passes away

4.       If you are moving to a new residence

5.       You are discontinuing a group plan

6.       You are losing your eligibility to your group health insurance

7.       You are cancelling your COBRA

8.       You have reached the age limit for dependents

Healthy NY Summary of Benefits:

• Physician care – diagnostic, treatment, consultant, referral services
• Surgery and anesthesia
• Inpatient hospital care, service and supplies
• Outpatient treatment
• Tests prior to admission
• Emergency service
• Second opinion for cancer and surgery
• Post-surgery or hospital confinement home care (maximum of 40 visits in a year)
• Post –surgery or hospital confinement physical therapy (maximum of 30 visits in a year)
• Adult preventive care
• Pre-natal care
• Well-child visits
• Children’s immunization
• Supplies and equipment for Diabetics
• Diagnosis x-ray
• Laboratory services
• Radiation therapy
• Chemotherapy
• Dialysis
• Blood and blood products in line with surgery or hospital stay

There are 2 available HIP Healthy NY plans:

• HIP Healthy NY HMO 2 with drug option – Current premium  rate is $404.87

• HIP Healthy NY High Deductible Health Plan 2 with drug option – Current premium  rate is  $329.77

Expect these rates to increase once every year.

Healthy NY has a comprehensive health care benefits package but since premiums are cost-effective, there are some benefits that will not be covered.

1.    Mental care services, treatment and medication

2.    Chiropractic

3.    Treatment for alcohol and substance abuse

4.    Home health care only if it follows hospital stay or surgery

5.    Physical therapy only if it follows hospital stay or surgery

6.    Hospice

7.    Ambulance

8.    Dental

9.    Vision

10.  Hearing aids

11.  Health care services outside of New York unless it’s an emergency situation

Browse through the HIP website to know more about HIP Healthy NY.