subject: Information on Aetna Healthy NY [print this page] Information on Aetna Healthy NY Information on Aetna Healthy NY
Aetna is among the top health insurers in the U.S. Aetna has been in existence since 1853. They began in Hartford, Connecticut. They offer coverage for health care, dental care, disability, pharmacy, group life and long term care. Their network is strong with over 561,000 physicians and specialists and 5,300 hospitals.
The mission of Aetna is to help people achieve health and financial security by providing easy access to safe, cost-effective, high-quality health care and protecting their finances against health-related risks to individuals, employers, college students and government employees.
18.468 people trust Aetna for their health insurance needs; 13.747 million people rely on Aetna for dental care solutions and 9.415 million people Americans depend on them for pharmaceutical coverage.
Among the plans Aetna offers is Healthy NY. It is a state-sponsored health insurance program that provides comprehensive coverage to individuals both self-employed and employed as well as sole-proprietors with not more than fifty employees.
There are certain qualifications for Healthy NY application. Below are the requirements to apply:
You should be a resident of the state of New York;
You must be ineligible for Medicare;
Your total gross household income should be within the limit set by the Healthy New York program;
You must currently be a sole-proprietor or an employee on a full-time, part-time or periodic basis;
You must be uninsured for the past 12 months except for some qualifying reasons (see below)
You should have no health benefits from your employment
Eligibility exceptions:
Loss of employment
Change to a new employer
Death of a family member
Change of residence
Discontinuation of a group health plan
Termination or cancellation of COBRA coverage
Change in marital status
Loss of eligibility for group health insurance coverage
Reaching age limit for dependent coverage
Summary of benefits for Healthy NY:
Physician services including diagnostic, treatment, consultant, and referral services
Surgical services (including breast reconstruction surgery after a mastectomy) and anesthesia
Inpatient hospitalization including room and board, general nursing care, special diets,
and other hospital services and supplies
Outpatient hospitalization including diagnostic and treatment services and surgical facility charges
Pre-admission testing
Emergency services (ambulance not covered)
Second opinion for surgery and cancer treatment
Post-surgery or post-hospitalization home health care, up to 40 visits per calendar year
Post-surgery or post-hospitalization physical therapy, up to 30 visits per calendar year
Adult preventive services including mammogram, Pap test, prostate cancer screening,
physical examinations no more than once every three years, and adult immunizations
Prenatal care, well-child visits, and children's immunizations
Diabetic supplies, equipment, and self-management education
Diagnostic, X-ray, and laboratory services
Radiation therapy, chemotherapy, and dialysis
Blood and blood products provided with surgery or inpatient hospitalization
Aetna offers 4 Healthy New York plans -
Aetna Healthy NY HMO 1 (without prescription coverage) -Current premium rate is $365.00
Aetna Healthy NY HMO 2 (with prescription coverage) - Current premium rate is $413.00
Aetna Healthy NY High Deductible Health Plan 1 (without prescription coverage) - Current premium rate is $280.00
Aetna Healthy NY High Deductible Health Plan 2 (with prescription coverage) - Current premium rate is $319.00
*Annual premium rates increase annually.
There are certain services that will not be included in the streamlined benefit package of the Healthy NY Health Insurance such as :
Mental health services and prescription drugs related to mental health conditions,
including treatment for depression, anxiety, and attention deficit hyperactivity
disorder (ADHD)
Alcohol and substance abuse treatment and prescription drugs related to alcohol
and substance abuse treatment
Chiropractic care
Physical therapy, unless post-surgery or post-hospitalization
Home health care, unless post-surgery or post-hospitalization
Hospice care
Ambulance
Dental, vision, and hearing aids
Out-of-state treatment, unless in the case of an emergency
If you want to know more about Aetna Healthy NY, visit the Aetna website.
