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Insurance

HSS West Side ASC participates in a growing number of major insurance plans.

Please note: The information listed below only applies to HSS West Side 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.

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.

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 note: The HSS West Side ASC is in the process of finalizing its participation agreements with the following plans: Aetna, Empire Blue Cross and Blue Shield, and EmblemHealth (HIP, GHI, Connecticare Plans). Please contact the HSS Insurance Advisory Service for further information regarding the HSS West Side ASC’s plan participation and regarding Medicare, Medicaid, No Fault and Worker’s Compensation status.

(click the insurance company name for more details)

HSS West Wide ASC is an in-network provider with the following Aetna programs:

  • HMO
  • POS
  • PPO
  • QPOS
  • Choice
  • Elect Choice
  • Managed Choice
  • Open Access
  • POS/POS II
  • Select
  • NY Community Plan
  • Signatures Administrators PPO

HSS West Side 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 West Side ASC is NOT an in-network provider for Empire's Medicare Managed/Advantage and Medicaid Managed Care plans.
  • The Empire Plan/New York State Health Insurance Program (NYSHIP)
    HSS West Side 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 West Side ASC and Participating Physicians are contracted directly with the Empire Plan/NYSHIP. Empire BCBS and United Healthcare are utilized only for administrative purposes.

HSS West Side ASC is an in-network provider with the following Cigna programs:

  • EPO
  • HMO
  • POS
  • PPO
  • Indemnity
  • Open Access

Exceptions:

  • HSS West Side ASC is NOT an in-network provider for Cigna's Medicare Managed Care/Advantage and Connect Network Plans

HSS West Side ASC is an in-network provider with the following EmblemHealth programs:

  • Connecticare Commercial
  • GHI CBP (NYC Healthline)
  • GHI National Network
  • GHI Network Access Network
  • GHI Tristate Network
  • EmblemHealth – Select Care Network (Large Group Only)
  • HIP Prime Network (Including: CHP Plans)
  • HIP Bridge Network
  • HIP Vytra

Exceptions:

  • HSS West Side ASC is NOT a participating provider with Emblem Medicare and Dual Advantage Plans
  • HSS West Side ASC is NOT a participating provider with Emblem Medicaid, HARP and Essential Plans
  • HSS West Side ASC is NOT a participating provider with Connecticare through Access Health CT, EmblemHealth Select Care Network (Exchange, Individual and Small Group) and the HIP Millennium Network

HSS West Side 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

HSS West Side ASC is an in-network provider with the following Oxford programs:

  • Freedom Network
  • Liberty Network
  • Metro Network

Exceptions: 

  • HSS West Side ASC is NOT an in-network provider for AARP Medicare Complete HMO Plans

HSS West Side ASC is an in-network provider with the following UnitedHealthcare programs:

  • HMO (Choice, Select Plus)
  • POS (Choice Plus, Select Plus)
  • EPO
  • PPO
  • Indemnity
  • UnitedHealthcare Compass

Exceptions:

  • HSS West Side ASC is NOT an in-network provider with UnitedHealthcare’s Medicare Managed Care/Advantage plans, NYS Essential, UHC Community Plan of NY Medicaid, or HARP

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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