Hospitals

What about hospital coverage?

In the Downstate 13:

The NYCE PPO will allow you to visit all major hospital networks in the nation. In the NY Downstate 13, this coverage will be provided by EmblemHealth and includes but is not limited to NYU Langone, Northwell Health, New York-Presbyterian, Mount Sinai, Montefiore, Memorial Sloan Kettering (MSK), Hospital for Special Surgery (HSS) and NYC Health and Hospitals (H+H). See a full list of hospitals in the Downstate 13.

Outside of the Downstate 13 in New York and nationwide:

NYCE PPO will utilize UnitedHealthcare’s Choice Plus network outside the Downstate 13, which will provide broad hospital coverage nationwide. Choice Plus is considered one of the most extensive PPO networks. The chart below provides some examples of the hospitals around the country that will be in network. Keep in mind this chart is not a complete list of all in-network hospitals and does not include all states, but all states are covered in the plan. Use the lookup tool below to explore more on your own.

State	Hospital Count	Partial List of In-Network Large Health Care Systems/Hospitals
AZ	84	Mayo Clinic Arizona Phoenix Children’s Hospital St. Joseph’s Hospital and Medical Center
CA	335	UCSF Medical Center Palo Alto Medical Foundation Lucile Packard Children’s Hospital UC Davis Medical Center
CT	40	Hartford Hospital Greenwich Hospital Yale Medicine Stamford Hospital
DE	10	Christiana Hospital Beebe Medical Center Bayhealth Hospital Kent Campus
FL	242	Baptist Hospital of Miami Advent Orlando H Lee Moffitt Cancer Center University of Miami Hospital
GA	141	Northside Hospital Piedmont Hospital Kennestone Hospital Northside Hospital Forsyth
MA	91	Boston Children’s Hospital Massachusetts General Hospital Brigham and Women’s Atrius Health
MD	52	University of Maryland Medical Center Luminis Health Anne Arundel Medical Center Adventist Health Shady Grove Medical Center Privia Medical Group
NC	131	Duke University Hospital Carolinas Medical Center Moses Cone Health System Novant Health Presbyterian Medical Center Rex Hospital
NV	41	Renown Regional Medical Center Sunrise Hospital and Medical Center Summerlin Hospital Medical Center Mountainview Hospital
NJ	82	Morristown Medical Center Hackensack University Medical Center Summit Medical Group Valley Hospital Robert Wood Johnson Medical Center Jersey Shore University Medical Center
PA	223	Children’s Hospital of Philadelphia Hospital of the University of Pennsylvania Lehigh Valley Hospital Magee Women’s Hospital of UPMC
SC	69	Medical University Hospital Authority Spartanburg Medical Center Trident Medical Center  Piedmont Medical Center
TN	116	Centennial Medical Center Vanderbilt University Medical Center Lebonheur Children’s Hospital University of Tennessee Medical Center
TX	495	Texas Children’s Hospital UT Southwestern University Hospital MHHS Herman Hospital Kelsey-Seybold Clinic
VA	100	Inova Fairfax Hospital VCU Health System UVA Health Sciences Center Inova Loudoun Hospital Winchester Medical Center

You can use UnitedHealthcare’s online lookup tool to see in-network hospitals in specific areas.

Click Shopping Around
Click Choice Plus
Click Places
Click Hospitals
Put in your location and adjust the “within how many miles” filter.

Will the NYCE PPO plan place hospitals in different tiers with different benefit levels and out-of-pocket costs?

There is no tiering of hospitals in the NYCE PPO. Members will incur the same out-of-pocket costs at all hospitals, with the exception of NYC Health + Hospitals, MSK and HSS, which will remain preferred providers with low-cost or $0 copays for services.

The NYCE PPO plan, like the GHI CBP plan, allows for the option of tiering in the future to penalize hospitals that price gouge or act in bad faith.