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HIP Health Plan

HIP Health Plan is the biggest HMO operating in New York City today. The HIP Health Plan network includes over 160 hospitals including key acute care centres in New York, Connecticut and Massachusetts, all of which provide quality health care to HIP Health Plan members.

HIP Health Plan Ratings

  • 2.0
  • 2.0
  • 1.0
  • 2.0
  • 1.8
    overall rating

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With a large and wide ranging network of health care professionals, HIP Health Plan offers great coverage to its members. The doctors who are a part of the plan all work in multi-specialty outpatient medical centres, many of which are associated with some of the best hospitals in New York City. Included on the HIP Health Plan rolls are St. Luke’s- Roosevelt Hospital Center, Beth Israel Medical Center, Lenox Hill Hospital, Montefiore Medical Center and St. Barnabas Medical Center. The HIP Health Plan also includes many doctors who work out of their private offices as well.

The HIP Health Plan network numbers approximately 43,000 doctors and other health care professionals. When you add in the staff of HIP Health Plans subsidiaries there are over 72,000 health care facilities available to members in New York, Connecticut and Massachusetts. In 2005, ConnectiCare, one of the largest health care providers in Connecticut, became a part of the HIP Health Plan network.

HIP Prime is the HIP Health Plan HMO. HIP Prime offers extensive coverage with services provided by an ever growing network of health care professionals. The HIP Prime plan offers low cost premiums, access to a large network of participating doctors and specialists as well as discounts on wellness services.

The HIP Health Plan Access program offers additional benefits to the regular HMO programs. These additional services include the fact that you do not need a special referral to see the doctor of your choice. HIP Health Plan Access subscribers can pick from over 25,000 physicians and specialists working in more than 40,000 locations. With the HIP Health Plan Access program you will also the possiblity to use some of New York’s best hospitals and doctor’s practices.

The HIP Health Plan Access program has no deductible and no co-insurance. 100% coverage is offered after you meet the co-pay for the majority of network services.

Another option available from HIP Health Plan is the HIP Classic program. This plan offers businesses high quality, economical health insurance for small groups. It has a structured rate system that enables clients to opt for the coverage the works best for their company’s employee health insurance requirements.

Members of the HIP Health Plan Classic program have access to a large network of multi-specialty doctors groups as well as medical groups who are affiliated with the best hospitals in New York. Primary care doctors visits start at $15 and there is 100% coverage after you meet the co-pay across the majority of network services.

The HIP Health Plan Plus Direct program is a New York State Point of Service (POS) option that is available only to direct pay eligible individuals in the HIP catchment area. Direct pay members are those people who buy their health care polices directly from the HIP Health Plan rather than participating in a company sponsored program.

There are co-pays for using in-network benefits. There is also the possibility for members to use non HIP Health Plan network medical facilities which would incur co-insurance and deductibles.

HIP Health Plan Choice Plus Direct offers prescription drugs with annual deductible when they are prescribed by network health care professionals. There is no out-of-network prescription drug coverage available.

A lifetime maximum for the total out-of-pocket expenses limits the amount of out-of-network benefits that you can claim as a member of the HIP Health Plan Choice Plus Direct program. Members can also use a network of independent doctors in their own practices and they also have the option of using multi-specialty groups of physicians.