Health Plus was established in 1984 and now serves in all five boroughs of New York City as well as Nassau County.  Close to 290,000 members are enrolled in Health Plus' programs.  They are ranked eighth in New York Business list of the largest managed care organizations in New York City. 

 

In 2008, Health Plus created Health Plus Elite, which is a Medicare Care Plan for senior citizens.  In 2009, Health Plus launched Health Plus Elite health maintenance organization (HMO), a new Medicare plan for beneficiaries with special needs. Health Plus Elite is the Medicare Advantage Plan, the Medicare Prescription Drug Plan, and the Medicare Special Needs Plan.

 

Medicare Advantage Plan Members pay a $27 monthly premium in addition to the monthly Medicare Part B premium.  For in-network Meciare Part B, the yearly deductible is $135.  Under the plan the beneficiary must go to in-network doctors, specialists and hospitals, and a referral is required for those specialists and hospitals.  For impatient hospital care, the beneficiary pays a $1,068 deductible for days 1-60.  For a skilled nursing facility, the beneficiary pays $0 for days 1-20 and $133.50 for days 21-100 per day.  Beneficiaries pay 20% of the cost for each primary care doctor visit and specialist visit.

 

Medicare Prescription Drug Plan - The Medicare Advantage Prescription Drug Plan covers mainly senior citizens.  Health Plus Elite HMO supplies service under the traditional Medicare plan as well as Medicare Part D which covers prescription drug benefits.  Health Plus Elite HMO provides to its members $250,000 a year for emergency services outside the U.S., some dental services, hearing services with $500 towards hearing aids every two years, $100 towards eyeglasses every year, as well as non-emergent transportation up to 4 roundtrips.

 

Medicare Special Needs Plan - Eligible for this coverage are those who are institutionalized or who are Medicare and Medicaid dual-eligible, or who have a severe or disabling condition.  Health Plus Elite HMO provides to its members a $0 co-pay for in-network doctors, hospitals, home health care, and lab work.  Hearing services with $500 towards hearing aids every two years, some dental coverage, 250,000 a year for emergency services outside the U.S., as well as non-emergent transportation up to 4 roundtrips are also provided under Health Plus Elite.