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HIP
Plan of New York
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Plan of NY
Plan Outline
The HIP plan follows the concept of total prepaid group practice hospital and medical care, that is, there is no out-of-pocket cost to the staff member for covered services at numerous participating medical groups in the Greater New York area. The costs of necessary emergency treatment obtained outside the covered area are included in the plan coverage. Additionally, prescription drugs (a $5 co-payment applies) and medical appliances (in full) are covered when obtained through HIP participating pharmacies and are prescribed by HIP physicians or any physician in a covered emergency. HIP participants may select a physician at a HIP medical centre or from a listing of 31,000 affiliated physicians for primary care services. The affiliated physician is visited in his or her private office. If you require specialty care, your primary care physician will refer you to a HIP specialist with a referral form. To select an affiliated physician, the HIP participant should call HIP at (800) HIP-TALK, go to the web site at www.HIPUSA.com or call the physician you wish to visit. The web site is available in Spanish, Chinese and Korean. Any language may also be accessed through (800) HIP-TALK. Additional information regarding HIP providers will be provided to participants during the annual enrolment campaign and also mailed by HIP to all participants upon request.
Premium
The premiums for the HIP HMO plan will increase by 9.8% this year. The premium rates and related percentages of salary contribution are shown on the schedule of premiums.
Benefits
Benefits under the HIP plan will remain unchanged in the renewal period. The package of benefits under the HIP plan is itemized in the plan summary.
Worldwide emergency care
Participants are covered 100% for emergency treatment anywhere in the world. The member needs to call his primary care physician. In some cases air transport would also be covered to return to New York.
Discount prescription drug programme
Prescriptions for maintenance drugs are $2.50 per month through Medco Health Solutions Mail Order Service (www.medco.com). Up to a 90-day supply can be requested. Once you have an account at Medco Health Solutions your physician may call to re-order or place another maintenance prescription order. The address and telephone number is:
Medco Health Solutions
P.O. Box 30496
Tampa, FL 33630-3496
Telephone: 1-800-473-3455 (press 0 to speak with a representative)Vision care
Participants are covered 100% for a routine annual eye examination at affiliated optometrists. Prescription lenses and frames from a select group cost $45 and are available every 24 months. Participants are not required to purchase the eyewear from the same provider rendering the eye examination. Lasik surgery discounts are available through Davis Vision.
Dental
Participants are able to have cleanings every six months for a $10 co-payment. Children additionally may receive fluoride treatment for a $10 co-payment. All other services are covered based on a discounted fee schedule. The fee schedule is available with new member information or by consulting the HIPUSA.com web site.
HIP's Internet site
Subscribers in the HIP plan are encouraged to activate an account on the HIP web site which permits participants to more effectively manage their coverage. The site is: www.HIPUSA.com. Participants can access their benefits and perform the following tasks: