Send Claims To Empire Blue Cross Blue Shield PO Box 3876, Church Street Station New York, NY
When did nyship replace Empire plan Medicare RX?
To help you remember to enroll in Medicare, NYSHIP will send you a letter and Medicare information packet a few months before your 65 th birthday. ... Medicare-primary Empire Plan enrollees and dependents will automatically be enrolled in Empire Plan Medicare Rx, a Medicare Part D prescription drug program with expanded coverage designed ...
How will my Medicare benefits work with my nyship coverage?
However, if you need to submit a claim for non-network services, simply print the attached form, complete the necessary information and mail it to the address on the form. Or, you may email using UnitedHealthcare's secure email link: https://nyrmo.optummessenger.com/public/opensubmit. Faxed claims are also acceptable …
What do I need to make a claim with Empire plan?
Links and Phone Numbers: Social Security Administration: http://www.ssa.gov, 1-800-772-1213. Medicare: http://www.medicare.gov, 1-800-MEDICARE (633-4227) Empire Plan Medicare Rx: 1-877-769-7447, Option 4. Click here to order a printed …
What should I do when I pay my Empire Plan bill?
The Federal Medicare Part D program, that provides prescription drug coverage to Medicare enrollees, took effect on January 1, 2006. The Employee Benefits Division sends a Medicare Part D Prescription Drug Program letter annually to all active and retired NYSHIP enrollees who are or have a dependent that is either 64 or older or eligible for ...
How do I submit a claim to empire?
If you visit a network provider, he/she will submit your claim on your behalf. However, if you need to submit a claim for non-network services, simply print the attached form, complete the necessary information and mail it to the address on the form.
Is the Empire Plan A Medicare Advantage Plan?
Empire BlueCross BlueShield is a Medicare Advantage plan with a Medicare contract.
Is Empire Nyship Medicare?
If you are in The Empire Plan or in a NYSHIP HMO that coordinates with Medicare, your NYSHIP plan becomes your secondary coverage (pays health insurance claims after Medicare). As the secondary payer, your NYSHIP plan will not cover expenses that Medicare would cover.
Does Empire Plan pay Medicare deductible?
The Empire Plan pays for much of the Medicare Part A and B deductible and coinsurance amounts if you use The Empire Plan provider network, and may pay for some other medical expenses not paid by Medicare.
What is Empire Medicare?
Empire Medicare-related coverage offers Medicare-eligible retirees protection from costly health care by filling the gaps in Medicare coverage. At a Glance. Plan Type: Medicare Supplemental Plan. Geographic Service Area.
What is the difference between the Empire Plan and the Excelsior plan?
"What is the difference between The Excelsior Plan and The Empire Plan?" The Excelsior Plan is a more affordable alternative to The Empire Plan. It offers many of the same features and benefits of The Empire Plan, with a higher degree of cost sharing between the employer and plan participants.
Is Nyship the same as Empire plan?
The Empire Plan is NYSHIP's unique health insurance plan designed exclusively for New York State's public employees and employers. The Empire Plan pays for covered hospital services, physicians' bills, prescription drugs and other covered medical expenses.
What is the group number for the Empire Plan Nyship?
For more information, call The Empire Plan toll free number at 1-877-7-NYSHIP (1-877-769-7447) and press 1 for the Medical Program.
Is Nyship United Healthcare?
Your SEHP medical coverage will be through insurance carriers under contract with NYSHIP: Empire Blue Cross Blue Shield (for hospital benefits), UnitedHealthcare Insurance Company of New York (medical/surgical), GHI/ValueOptions (mental health and substance abuse) and CIGNA/Express Scripts (prescription drugs).
Does NYS reimburse Medicare premiums?
Medicare Part B Premium Reimbursement When Medicare is primary to NYSHIP coverage, NYSHIP reimburses you for the standard Medicare Part B premium you pay to SSA, excluding any penalty you may pay for late enrollment.
What is the Medicare Part B reimbursement?
The Medicare Part B Reimbursement program reimburses the cost of eligible retirees' Medicare Part B premiums using funds from the retiree's Sick Leave Bank. The Medicare Part B reimbursement payments are not taxable to the retiree.
What does the Empire plan cover?
The Empire Plan Hospital Program, administered by Empire BlueCross, provides coverage for inpatient and outpatient services provided by a hospital or skilled nursing facility and hospice care.
How to contact Empire Plan?
Empire Plan Medicare Rx: 1-877-769-7449, Option 4. New York State Employee Retirement System: 1-866-805-0990, https://www.osc.state.ny.us/retire. Click here to order a printed copy of the Medicare and NYSHIP booklet with DVD.
How to coordinate Medicare with NYShip?
To coordinate Medicare with your NYSHIP benefits, you should make sure that you: Contact the Social Security Administration (SSA) to enroll in Medicare three months before your birthday month. Visit https://www.ssa.gov/onlineservices or call 1-800-772-1213.
How to get reimbursed for IRMAA?
To be reimbursed for IRMAA, you must complete the IRMAA Reimbursement Request application (below) and submit it to the Employee Benefits Division along with proofs of payment of your Medicare Part B premium.
When does NYSHIP start?
NYSHIP automatically begins reimbursement for the standard cost of original Medicare Part B when Medicare becomes primary to NYSHIP coverage at age 65 for retirees, vestees, dependent survivors, and enrollees covered under Preferred List provisions, and their dependents who turn 65.
When does Medicare become primary to NYShip?
When you are no longer actively employed, Medicare will become primary to NYSHIP for any Medicare-eligible dependents as of their initial eligibility date. Enrollment in Parts A and B is required to maintain coverage under NYSHIP for anyone who is eligible for primary coverage under Medicare.
When will NYSHIP send you a letter?
To help you remember to enroll in Medicare, NYSHIP will send you a letter and Medicare information packet a few months before your 65 th birthday.
Does Medicare work with NYShip?
This page has information about how your Medicare benefits will work with your NYSHIP coverage.*. Medicare becomes your primary insurer when you are eligible for Medicare and enrolled in NYSHIP as a retiree, vestee, dependent survivor, or are covered under Preferred List provisions.
What information do you need to complete an Empire Plan claim?
If you go to an Empire Plan participating provider, MPN Network provider, or a MultiPlan provider, all you have to do is ensure that the provider has accurate and up-to-date personal information (name, address, health insurance identification number, signature) needed to complete the claim form. Your participating provider, MPN Network provider, HCAP-approved provider or MultiPlan Program provider fills out the form and sends it directly to UnitedHealthcare. The claim forms are in each provider's office.
How to submit a claim for non-network services?
However, if you need to submit a claim for non-network services, simply print the attached form, complete the necessary information and mail it to the address on the form.
Is the Empire Plan there?
It's good to know that The Empire Plan is there wherever you or your family goes.
Is Empire Plan coverage available worldwide?
Empire Plan coverage is available worldwide , and not just for emergencies. Most parts of The Empire Plan have two levels of benefits. If you use an Empire Plan participating provider, you will receive covered services and supplies at little or no cost and have no claim forms to fill out. If you use a non-participating provider, medically necessary services and/or supplies are covered, but deductibles, coinsurance and benefit limits may apply
How to coordinate Medicare with NYShip?
To coordinate Medicare with your NYSHIP benefits, you should make sure that you: Contact the Social Security Administration (SSA) to enroll in Medicare three months before your birthday month. Visit https://www.ssa.gov/onlineservices or call 1-800-772-1213.
When will Medicare cards be mailed?
New Medicare cards will be mailed to all Medicare enrollees beginning in April 2018. Your new card will have a unique ID called a Medicare Beneficiary Identifier (MBI) that will replace the SSN-based Health Insurance Claim number (HICN) on new Medicare cards.
When will Medicare remove Social Security numbers?
In an ongoing effort to fight medical identity theft and fraud, the Centers for Medicare and Medicaid Services (CMS) has been mandated to remove Social Security Numbers (SSNs) from all Medicare cards by April 2019.
Who is required to send a notice of creditable coverage for Medicare Part D?
The Employee Benefits Division is required to send an annual notice of Creditable Coverage for the Medicare Part D Prescription Drug Program to all active and retired NYSHIP enrollees and dependents who are 65 or older, or are eligible for Medicare due to disability.
When do you have to notify Medicare?
If you are eligible for Medicare before age 65, you must notify the Employee Benefits Division that you have enrolled in Medicare Parts A and B, and provide a copy of your Medicare card.
Who administers medicaid?
Both are administered by the Centers for Medicare and Medicaid Services (CMS). Medicaid is a health insurance program for low-income persons of any age, is jointly funded by federal and state governments, and is usually administered at the county or local level.
Does Medicare work with NYShip?
This page has information about how your Medicare benefits will work with your NYSHIP coverage.*. Medicare becomes your primary insurer when you are eligible for Medicare and enrolled in NYSHIP as a retiree, vestee, dependent survivor, or are covered under Preferred List provisions.
Medicare Part D Information
The Federal Medicare Part D program, that provides prescription drug coverage to Medicare enrollees, took effect on January 1, 2006.
Empire Plan Medicare Rx Prescription Drug Program
Effective January 1, 2013, NYSHIP replaced the Empire Plan Prescription Drug Program coverage for Medicare-primary enrollees and dependents with Empire Plan Medicare Rx (PDP), a Medicare Part D prescription drug program with expanded coverage designed especially for NYSHIP.
GRS Hearing Aid Coverage Update
Many Group Retiree Solutions (GRS) plans now include the requirement that all hearing aids be supplied by Hearing Care Solutions (HCS).
More Resources
Electronic Data Interchange (EDI) is the computer-to-computer exchange of business documents in a structured format. EDI provides a faster and cleaner method for delivering time-dependent data, saving you time compared to filing paper claims.
Customer Service and Support
Have questions about a claim, need help finding a provider, or have a question about a medical facility? We’re here to help. Call during our business hours or mail claims to the addresses provided.
Vision
As your health needs evolve, our diverse plans are designed to evolve with you. With three rich options to choose from, we’ve got you covered.