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NYC Health Benefits Program
Choosing a Health Plan
Contact all the plans in which you are interested for benefits packages and provider directories. To select a health plan that best meets your needs, you should consider at least four factors:
Coverage - The services covered by the plans differ. For example, some provide preventive services while others do not cover them at all; some plans cover routine podiatric (foot) care, while others do not.
Choice of Doctor - Some plans provide partial reimbursement when non-participating providers are used. Other plans only pay for, or allow the use of, participating providers.
Convenience of Access - Certain plans may have participating providers or centers that are more convenient to your home or workplace. You should consider the location of physicians’ offices and hospital affiliations.
Cost - There is no cost for basic coverage under some of the health plans offered through the City Health Benefits Program, but others require a payroll or pension deduction. Additional benefits (e.g., prescription drug coverage) may be available through an Optional Rider. These costs are compared on charts available on this website. Some plans require copayments for certain services. Some plans require you to pay a yearly deductible and coinsurance before the plans will reimburse you for the use of non-participating providers. If a plan does not cover certain types of services that you expect to use, you must also consider the out-of-pocket cost of these services. The plan you have chosen will send you information regarding your health benefits coverage when you enroll.
NOTE - Double City Coverage Prohibited
If a person is eligible for the City program as both an employee/retiree or a dependent, the person must choose one status or the other. No person can be covered by two City health contracts at the same time. Eligible dependent children must all be enrolled as dependents of one parent. If either spouses or domestic partners are eligible and one is enrolled as the dependent of the other, the dependent may pick up coverage in his or her own name if the other’s contract is terminated.
