The Empire Plan or a NYSHIP HMO Plan
Regardless of whether you choose The Empire Plan or a NYSHIP HMO, your insurance coverage provides you and your eligible dependents with all of the following medical services:
- Hospitalization and coverage for hospitalization related expenses
- Medical and surgical care coverage
- Mental health and substance abuse treatment programs
- Prescription drug coverage
HMOs approved for participation in NYSHIP are not available in all geographic areas so keep in mind that enrollment in a NYSHIP HMO requires that you must live or work in that HMO’s NYSHIP approved service
area. Once you can’t meet the requirement of living or working in that NYSHIP HMO’s service area anymore, you will need to change options. On top of this, benefits provided by The Empire Plan and the HMOs differ. Either option that best meets your needs, will have coverage you can use at our treatment facility. You and your dependents will have the same option.
The Opt-out Program
The one exception would be if you’ve taken the Opt-out Program which offers incentive payments to eligible New York State employees who opt-out of NYSHIP health benefits. The program is available to eligible employees who already have other employer-sponsored health insurance. This would change the equation and you’d need to check where you have coverage and what type of coverage you have before we can move forward with your enrollment.
