Are you a start-up? Can’t afford coverage? Is your Aetna Healthy NY ending?
Healthy NY insurance program was designed to promote and provide affordable insurance coverage to eligible small businesses without health insurance coverage for their employees and, also, for eligible working uninsured.
The Healthy NY program includes benefits that cover essential health needs including:
- Inpatient and outpatient hospital services
- Physician services
- Maternity care
- Preventative health services
- Diagnostic and x-ray services
- Emergency services.
Applicants may now also choose a benefit package with a limited prescription drug benefit or a benefit package without a prescription drug benefit.
RECERTIFICATION: Healthy NY will only be available to groups with 1-50 FTE’s in 2018 per guidance from the NYS DFS. Please see the attached guidance released. It is important to note that while the definition of “small employer” is increasing from an employer with 50 or fewer employees to an employer with 50 to 100 employees as of January 1, 2016, only employers with 50 or fewer employees will be eligible for Healthy NY. Please see on page 2 of the attached here
| Metallic Level | Gold | ||||
| Product/Network/Gatekeeper | G HNY HMO Metro Gated OHP | ||||
| InNetwork Copayment | $25/$40 | ||||
| Out of Network Reimbursement | N/A | ||||
| InNetwork Coinsurance % | 80% | ||||
| InNetwork Maximum Out of Pocket | $4000/$8000 | ||||
| InNetwork Deductible | $600/$1200 | ||||
| Out of Network Coinsurance % | N/A | ||||
| Out of Network Maximum Out of Pocket | N/A | ||||
| Out of Network Deductible | N/A | ||||
| Deductible Accumulation Period | Contract Year | ||||
| Pharmacy | $10/$35/$70 | ||||
| Dependent Cutff Age | 26 Dependent – Standard | ||||
For rates and eligibility