Changes to the city health plan affecting GHI-CBP and HIP in-service members and retirees who are not Medicare-eligible take effect on July 1.
Public school educators and all other New York City municipal employees will continue to have access to health coverage without an annual premium. GHI subscribers currently pay $15 when they visit their primary care physician, the most utilized service in the plan. That copay will not change.
New ID cards will be mailed in June to all GHI-CBP members and to HIP members who are using a primary care physician who is not in the new HIP Preferred network.
This spring, members received detailed information about the changes from both the UFT Welfare Fund and EmblemHealth.
The GHI-CBP copay changes are detailed in the table to the right.
One of the most expensive forms of care is hospital-based emergency room visits, which should be used only in a genuine emergency. In the hospital portion of the GHI-CBP plan (Empire BlueCross), the copay for an emergency room visit is rising from $50 to $150 on July 1. The $150 copay is waived, however, if you are admitted to the hospital within 24 hours.
GHI subscribers will no longer pay copays for preventive health care. All preventive health services — including immunizations, mammograms, prenatal vitamins, colonoscopies and birth control pills — will be available to GHI subscribers free of cost as of July 1.
HIP subscribers also will see changes in their health plan. HIP is introducing a new plan called HIP Preferred. HIP subscribers may see their doctor with no copay if he or she is in the HIP Preferred network. HIP subscribers now will have a $10 copay if their doctor is not in the HIP Preferred network.
Some HIP specialist services, regardless of the subscriber’s primary care physician, have different copays, such as emergency room visits, ambulatory surgery and hospital care.
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| Â Benefit | Current Co-pay | New co-pay |
|---|---|---|
| Primary care physician (participating GHI doctor) | $15 | $15 |
| Advantage Care Physician – generalist | $15 | No co-pay |
| Advantage Care Physician – specialist | $20 | No co-pay |
| All other specialist | $15 or $20 | $30 |
| Hospital emergency-room visit | $50 | $150 |
| Urgent care | $15 | $50 |
| MRI/CT (hi-tech radiology) | $15 | $50 |
| Diagnostic lab (such as blood or X-ray) | $15 | $20 |
| Physical therapy | $15 | $20 |