GetHealthHelp

A Patient Advocate's View

HMO Options for 2009

 

814.Empire BCBS NY

HMO

 

21.Aetna

 HCN NY

 

847.Aetna HMO

 

822.HIP NY

 

838.HealthNet NY/CT

 

Only doctors at participating hospitals will accept.

Bare Bones Coverage

 

Comprehensive Primary Care at a low cost.

 

Only doctors at participating hospitals will accept.

Bare Bones Coverage

 

VERY GOOD for Preventive Services for children and women’s care.

 

Doctors compare this coverage to Medicare HMO’s. Small Network

 

 

 

  $150 Hospital  co-pay

per admission added  

 

 

NONE

 

  $150 Hospital  co-pay

per admission added

$50 emergency room

 

 

 $100 Hospital  co-pay

per admission added

 

 

 $150 Hospital  co-pay

per admission added

 

no change

 

 

no change

 

 

no change

 

no change

 

no change

 

 

no change

 

 

no change

 

 

NONE

 

 

NONE

 

 

NONE

 

 

NO

 

70% covered after $250 deductible with limits on fees and procedures including hospital care

 

 

NO

 

 

NO

 

 

NO

 

Requires PCP Selection

Limits out of pocket cost

 

No out of Pocket for In Network doctors visits $15 co-pay for specialists

 

Requires PCP Selection

Pay only a $10 co-pay

 for office visits

 

Pay only a $10 co-pay

for office visits.

 

Pay only a $10 co-pay

for office visits.

 

$10 co-pay

 

Limited number of visits both in and out of network b Preauthorization and

 $1500 Annual Max.

 

 

Only limited in-network coverage with

 managed care  limits

 

 

Limited number of visits

in-network $10 co-pay

 

 

Limited number of visits

in-network $10 co-pay

 

 

Approved Services

in-network $10 co-pay

 

Authorization Required

$15 in network 50% out

 

Approved Services

in-network $10 co-pay

 

60 visits limit

in-network $10 co-pay

 

Approved Services

in-network $10 co-pay

November 9, 2008 - Posted by | Uncategorized

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