Off NY Health Exchange - Individuals Health Plans / Rates‏

If you are looking for individual health insurance for you or your family, please contact our office for assistance 631 499 1180 or service@thehabermangroup.com

General Overview
Most Health plans are divided into five metallic plan categories:

  • Platinum: Mainly Copay Only plans, normally no deductibles
  • Gold: Generally you must satisfy an annual deductible before your copays start
  • Silver: Generally you must satisfy an annual deductible before your copays start
  • Bronze: Most plans are considered High Deductible Health Plan (HDHP) and some are HSA Compatible
  • Catastrophic plan: Low cost option, only available for people under 30 years old, very limited coverage

Effective dates: Effective dates: 1st of the month only / Deadline to Enroll: Varies based on specific carrier

 

Do you need help with Individual health Insurance?

The Haberman Group is here to help as you navigate through the individual/family health insurance marketplace and can assist you with: enrollments, plan changes, coverage/billing questions, claim adjudication and more. Due to the insurance carrier's reduced/eliminated Broker Fees, we must charge our Individual Health clients an annual Administration Fee of $125.00. As always, you have the option of setting up your enrollment yourself and communicating directly with the carrier. If you would like us to assist you, complete the form below and submit an online payment for the annual Administration Fee.

First Name:
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Search the Carriers Provider Network(s)

Note:Searching for a provider via carrier's website, be sure to select the proper network as noted below. When you contact a providers offices: Please ask if they "PARTICIPATE" in the particular plan's network, rather than TAKE or ACCEPT.

OSCAR
NetworkOscar Circle
Click here: https://www.hioscar.com/search/001/doctors?year=2019&planType=INDIVIDUAL
Service area: Bronx, Kings, Nassau, Suffolk, New York, Queens, Richmond, Rockland, and Westchester counties
Traveling Outside of the service area: Emergency coverage only at a hospital, telemedicine service available

 

HEALTHFIRST
NetworkHealthfirst Total EPO
Click here: www.HFDocFinder.org
Service area: Manhattan, Bronx, Nassau, Suffolk, Queens, Brooklyn, and Richmond counties
Traveling Outside of the service area: Emergency coverage only at a hospital, telemedicine service available

 

EMBLEMHEALTH
Network: Select Care
Click here: https://www.emblemhealth.com/Find-a-Doctor
Service area: Bronx, Kings, New York, Queens, Richmond, Rockland, Westchester, Nassau, Suffolk, Albany, Columbia, Fulton, Greene, Montgomery, Rensselaer, Saratoga, Schoharie, Schenectady, Warren, Washington, Delaware, Dutchess, Orange, Putnam, Sullivan, Ulster, Broome, and Otsego counties
Traveling Outside of the service area: Emergency coverage only at a hospital, telemedicine service

 

EMPIRE BC/BS
Network: Pathway Enhanced (Not the National PPO)
Click here: https://www.empireblue.com/health-insurance/provider-directory/searchcriteria
Service area: Albany, Clinton, Bronx, Columbia, Delaware, Dutchess, Essex, Fulton, Greene, Kings, Montgomery, Nassau, New York, Orange, Putnam, Queens, Rensselaer, Richmond, Rockland, Saratoga, Schenectady, Schoharie, Suffolk, Sullivan, Ulster, Warren, Washington, and Westchester Counties
Traveling Outside of the service area: Emergency coverage only at a hospital, telemedicine service available
Please Note:  Empire currently does not have a side-by-side plan benefit overview sheet available.  If interested in an Empire plan, please advise us of the specific plan and we can provide you with a copy of the corresponding SBC (Summary of Benefits and Coverage) document.