Empire Blue Cross Blue Shield
Empire BCBS offers comprehensive health insurance plans for individuals, families, and businesses across New York.
View Empire BCBS NY Plans & Pricing in Your Area
All About Empire Blue Cross Blue Shield of New York
Empire BCBS is one of the largest health insurance carriers in New York, serving 28 eastern and southeastern counties.
Empire Blue Cross Blue Shield started in 1934. It continues to offer a vast portfolio of health insurance plans and quality health care services. It serves individuals, families, and employers across the United States.
Empire Blue Cross Blue Shield Health Insurance Plan Options
Empire BCBS NY offers many health insurance plans for individuals and families, on and off the exchange. Empire BCBS categorizes its Exchange-sold health plans into metal-tiers. Bronze plans have the lowest premiums while Platinum plans offer the highest premium levels and coverage benefits.
For plans sold off the exchange, they are categorized into:
Core
Core plans have low monthly premiums but have higher out-of-pocket costs when you get medical care. These plans also have higher deductibles, coinsurance, and copays than other plan types from Empire Blue Cross Blue Shield.
Essential
Unlike Core plans, you pay less when you get medical care with Empire Essential plan, but still have low monthly premiums.
Preferred
Preferred plans have higher premiums than Core and Essential plans. But they offer more health benefits. You also pay less when you get health care.
Premier
Premier plans offer the highest health care benefits. They also have the lowest out-of-pocket costs for covered services. Premier plans also have the highest monthly premiums compared to the three plans.
Why Choose Empire Blue Cross Blue Sheild?
Empire HealthChoice Assurance, Inc. and Empire HealthChoice, Inc. are independent licensees of the Blue Cross Blue Shield Association. Empire BCBS is also a subsidiary of WellPoint Inc.
For all plans, members get access to:
BlueCard® Program
Through this program, you’ll have health coverage for urgent and emergency care. It applies when you travel to another state.
24/7 NurseLine
Get medical information and help from registered nurses through Empire’s 24/7 NurseLine.
Doctor Tool
To find the nearest in-network doctor, hospital, or pharmacy, use the Doctor Tool app. You can use it on your PC or mobile phone.
Estimate Your Cost
This helps you compare the cost of common medical procedures and health care facilities in your area.
Empire Blue Cross Blue Shield: Pros & Cons
The BlueCross BlueShield Association licenses Empire Blue Cross Blue Shield and serves New York residents. It offers health plans for individuals, families, employers, and government programs. Here is an honest look at what members can expect:
Pros
- Extensive plan variety for nearly every situation: Empire Blue Cross Blue Shield offers many plan types. These include Medicaid, CHIP, Managed Long-Term Care, the Essential Plan, ACA marketplace plans, and catastrophic plans. This gives New Yorkers a realistic path to coverage across incomes and life situations.
- Strong, widely accepted provider network: Members praise Empire Blue Cross for fair co-payments. They also value its quality provider network. People across New York State widely accept the network.
- Multilingual member support: Empire’s NurseLine offers free medical advice in over 170 languages. Available 24 hours a day, and you can get help right away. This makes it one of New York’s most accessible support services.
- Comprehensive employer and wellness offerings: Employers can offer medical insurance with wellness programs. Employers can include the Sydney Health app. Employers can also offer dental, vision, life, and disability coverage. This gives businesses a true one-stop benefits option.
- Largest insurer in the state: Empire Blue Cross Blue Shield is large. This size gives it strong negotiating power with providers. It also has broad name recognition that many New Yorkers trust.
Cons
- Frequent claims denial and appeal complaints: Some members report that the company denies their claims without a clear reason. They must file long appeals and grievances to get coverage honored.
- Network gaps with some specialists: Some members struggle to find specialists, especially OB/GYNs, who accept Empire Blue Cross. This happens even when those providers accept nearly every other carrier.
- Customer service and communication issues: Members report long hold times when confirming out-of-state coverage. Phone and fax options only cover specific questions.
- Provider access delays: One member reported a three-month wait to see a general practitioner. The visit was for medication refills after moving from another state.
- High complaint volume: As the state’s largest insurer, Empire Blue Cross Blue Shield gets many complaints. Many involve enrollment confirmation and processing delays.
Bottom line: Empire Blue Cross Blue Shield offers New Yorkers a vast range of plan types. It also has a large, well-regarded provider network. The state’s largest insurer’s size and resources back these benefits.
The trade-off is inconsistent claims processing and customer service experiences that some members find frustrating. An HSA for America Personal Benefits Manager can help you compare Empire BCBS plans to other carriers near you. They will help you find the right fit at the right price. This service is free for you.
Ready to sign up for a Empire Blue Cross Blue Shield NY Plan?
At HSA for America, we guide you through questions that may come up. We help you find the right health insurance plan.
Our Personal Benefits Managers partner with you. They use all available money-saving tools. Their goal is to save you as much money as possible.
This professional relationship continues after you secure your health plan. It helps you meet your medical needs and save money.
Empire Blue Cross Blue Shield FAQs
Q: What types of plans does Empire BCBS offer?
A: Empire BCBS offers one of the widest plan selections among New York insurers. Plans include ACA marketplace options for individuals and families. It also offers employer-sponsored group coverage.
Other options include Medicaid, Child Health Plus, and Managed Long-Term Care. Empire also offers an Essential Plan for those who do not qualify for Medicaid. This range means most New Yorkers can find coverage through Empire BCBS, no matter their income or job status.
Q: How large is the Empire Blue Cross Blue Shield network in New York?
A: Empire Blue Cross Blue Shield has one of the largest provider networks in the state. Many doctors, hospitals, and specialists across New York accept it. As the state’s largest insurer, Empire Blue Cross Blue Shield has strong bargaining power with providers. This often means more in-network options for members than smaller regional carriers.
Q: What support services come with an Empire BCBS NY plan?
A: Members enrolled in an Empire BCBS NY plan can use the NurseLine service. It offers free, immediate medical advice in over 170 languages. The service is available 24 hours a day. Many plans also include the Sydney Health mobile app.
It helps manage pharmacy benefits, find providers, and track claims. In-person support is also available at Empire’s Community Service Centers across New York.
Q: What should I know before enrolling in Empire Blue Cross coverage?
A: Before you enroll in Empire Blue Cross coverage, know that experiences can vary. They may vary by plan type and region. While many members report fair co-payments and a strong provider network, others note longer claim wait times.
Some also have trouble reaching certain specialists. Comparing plan documents and talking with a licensed agent can help you choose the best option for your healthcare needs.
Q: Does Empire Blue Cross Blue Shield NY offer employer group plans?
A: Yes. Empire Blue Cross Blue Shield NY offers employer group benefits. These include medical insurance and wellness programs. They also include dental, vision, life, and disability insurance.
Life and disability coverage is through its affiliate, Anthem Life and Disability Company. Employers can also add voluntary supplemental benefits, like accident, critical illness, and hospital indemnity coverage. They can bundle multiple benefit types together. Options vary somewhat between upstate and downstate New York.
Q: How do I get a quote for Empire BlueCross BlueShield coverage?
A: You can request an instant online quote for Empire BlueCross BlueShield coverage by selecting your state above. You can also call our team directly.
Or, schedule a free consultation with a Personal Benefits Manager. They can compare Empire plans with other carriers in your area. This helps you find the most affordable coverage for your needs, and you won’t incur any cost.
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