Please note: The information listed below only applies to HSS ASC and is subject to change. The HSS Insurance Advisory Service can provide you with the most up-to-date information at 212.774.2607. For more information regarding specific physician practices, please contact the individual physician offices or HSS Connect at 877.606.1555.
Insurance
Live in New York State and need health insurance?
You can apply for health insurance through the Affordable Care Act (ACA) and purchase a qualified health plan during open enrollment. View the PDF below for more information.
- Affordable Care Act Open Enrollment Instructions
Important Phone Numbers
Insurance Advisory Service
212.774.2607
Financial Assistance Program
212.606.1505
Physician Referral Service
877.606.1555
Health insurers who provide access to HSS West Side ASC
Please contact the HSS Insurance Advisory Service for further information regarding the HSS ASC’s plan participation.
(click the insurance company name for more details)
Aetna
HSS ASC is an in-network provider with the following Aetna programs:
- HMO
- POS
- PPO
- QPOS
- Choice
- Elect Choice
- Managed Choice
- Open Access
- Select
- NY Community Plan
- Signatures Administrators PPO
Exceptions:
- HSS ASC is NOT an in-network provider for Aetna's Medicare Managed Care/Advantage, Medicaid, Savings Plus, NY Signature and QHP plans.
Blue Cross Blue Shield - Empire
HSS ASC is an in-network provider with the following Empire Blue Cross Blue Shield programs:
- EPO
- HMO
- POS
- PPO
- Indemnity
- Pathway Plans
- HealthPlus - Individual Network Only (Not Medicaid)
- NYC Healthline
- Empire Plan (NYSHIP / NYS Gov't Employee Benefits) – See Below Exception
- Federal Employees (FEP)
- Basic
- Standard
Exceptions:
- HSS ASC is NOT an in-network provider for Empire's Medicare Managed/Advantage and Medicaid Managed Care plans.
- New York State Employee Health Insurance Plan (Empire Plan/NYSHIP)
HSS ASC is an in-network provider for New York State employees covered by the “Empire Plan.” Please note: Empire Blue Cross Blue Shield administers your inpatient and outpatient hospital services under this plan. United Healthcare administers the network of physicians. HSS and Participating Physicians are contracted directly with the Empire Plan/NYSHIP. Empire BCBS and United Healthcare are utilized only for administrative purposes.
Blue Cross Blue Shield - Out-of-Area
HSS ASC is an in-network provider with the following Out of Area Blue Cross Blue Shield programs:
- Out of Area (Cards with PPO Suitcase logo)
- UniCare Affiliated PPO
Members of the UniCare Affiliated PPO plans have in-network access to HSS ASC through an affiliation with Empire Blue Cross Blue Shield.
Some, but not all, out-of-area Blue Cross Blue Shield plans include HSS ASC as an in-network provider through the National PPO BlueCard® Program. The BlueCard® program allows you to access in-network benefits from other local Blue Cross PPO plans and all authorized and covered services provided by the hospital would be subject to your in-network deductibles and coinsurance levels. The existence of the “PPO in a suitcase logo” on your member identification card typically confirms your plan’s participation in the BlueCard® program.
Cigna
HSS ASC is an in-network provider with the following Cigna programs:
- EPO
- HMO
- POS
- PPO
- Indemnity
- Open Access
Exceptions:
- HSS ASC is NOT an in-network provider for Cigna's Medicare Managed Care/Advantage and Connect Network Plans
EmblemHealth (Connecticare, GHI and HIP Plans)
HSS ASC is an in-network provider with the following EmblemHealth programs:
- Connecticare Commercial
- Connecticare Medicare
- GHI CBP (NYC Healthline)
- GHI National Network
- GHI Network Access Network
- GHI Tristate Network
- GHI Medicare
- EmblemHealth – Select Care Network (Large Group Only)
- HIP Prime Network (Including: CHP Plans)
- HIP Bridge Network
- HIP VIP Bold Network
- HIP VIP Prime Network (Including: Dual Eligible Plans*)
- HIP Vytra
- HIP Essential Plans
- HIP Enhanced Care Prime Network (Medicaid*)
- HIP Enhanced Care Plus Prime Network (HARP*)
Exceptions:
- HSS ASC is NOT an in-network provider with Connecticare through Access Health CT, EmblemHealth Select Care Network (Exchange, Individual, and Small Group), HIP Millennium Network, and HIP VIP Reserve.
Fidelis
HSS ASC is an in-network provider with the following Fidelis programs:
- Fidelis Medicaid
- Fidelis Child Health Plus
- Fidelis Essential Plan
- Fidelis HARP
Exceptions:
- HSS ASC is NOT a participating provider with Fidelis Medicare, Dual Advantage, and Exchange Plans.
Healthfirst
HSS ASC is an in-network provider with the following Healthfirst programs:
- Healthfirst Medicaid
- Healthfirst HARP
Exceptions:
- HSS ASC is NOT a participating provider with Healthfirst Essential, Healthfirst Leaf, or Healthfirst Medicare plans
Medicaid
HSS ASC is participating with Traditional New York State Medicaid insurance. You are responsible for any co-payments. If you are enrolled in a Medicaid Managed Care HMO and Child Health Plus plan your benefits and coverage may be limited. Please contact VOICES Medicaid Education Program at 212.774.2011 to determine your options.
Medicare
HSS ASC is participating with Traditional Medicare insurance. You are responsible for co-insurance and deductible costs. For further information please call the HSS Insurance Advisory Service at 212.774.2607 or email your question through our online form.
New York State Healthcare Exchange / Marketplace Plans
HSS ASC is participating with the following NYS Healthcare Exchange/Marketplace plans:
- Empire BCBS Healthplus Gatekeeper Individual Network
- United Healthcare – Compass
SEE PHYSICIANS PARTICIPATING WITH EMPIRE BCBS HEALTHPLUS GATEKEEPER INDIVIDUAL NETWORK
SEE PHYSICIANS PARTICIPATING WITH UHC COMPASS
No-Fault
HSS ASC accepts No-Fault Insurance. You must have a valid case/claim number and authorization (if applicable) prior to seeking care.
Oxford Health
HSS ASC is an in-network provider with the following Oxford programs:
- Freedom Network
- Liberty Network
- Metro Network
UnitedHealthcare
HSS ASC is an in-network provider with the following United programs:
- HMO (Choice, Select Plus)
- POS (Choice Plus, Select Plus)
- EPO
- PPO
- Indemnity
- United Healthcare Compass
- NYS Essential
- UHC Community Plan of NY Medicaid
- HARP
Exceptions:
-
HSS ASC is NOT an in-network provider with United Healthcare’s Medicare Managed Care/Advantage plans
Workers' Compensation
HSS ASC accepts Workers' Compensation. You must have a valid case/claim number and authorization (if applicable) prior to seeking care.
If you have specific questions regarding the plans with which HSS West Side ASC participates, please call the HSS Insurance Advisory Service at 212.774.2607 or email your question through our online form. The HSS Insurance Advisory Service can serve as a liaison service among you, your insurance carrier, and HSS West Side ASC to provide information regarding your insurance coverage. You may be responsible for payment of deductibles and co-insurance amounts, and you may be subject to other limitations, such as pre-certification requirements.
If HSS West Side ASC does not participate with your particular insurance plan, you still may have coverage subject to the availability of "out-of-network" benefits. The HSS Insurance Advisory Service can advise you.
Your surgeon, your anesthesiologist, your medical doctors, and other specialists make their own decisions regarding participation in insurance plans. There are many physicians affiliated with HSS West Side ASC who participate in the same insurance plans with which HSS West Side ASC itself participates. For more information regarding specific physician practices, please contact the individual physician offices or the HSS Connect at 877.606.1555.
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