Endowed Faculty, staff and covered dependents
The endowed health plans administered by Aetna provide coverage for medical services — the amount you pay varies depending upon if you choose to visit an in-network or out-of-network provider.
Where to start
Call Aetna toll free at 877-371-2007 to speak with a representative who can walk you through your coverage options on an individual basis. They will be able to identify in-network providers, advise about coverage under your plan, and let you know what steps, if any, that you can take to have a provider or service covered as in-network. When you call, have this information ready:
- the birth date of the member you’re calling about
- the first and last name of a preferred provider
Questions related to medications and drug coverage must be directed to OptumRx. Gather your list of medications and questions, then speak with a representative toll free at 866-533-6977.
Benefit details available online
Each endowed health plan’s Summary Plan Description will provide you with specifics regarding preauthorization and coverage. Find these documents under “Tools and Resources” on each plan’s overview page or visit the direct link below:
- The Aetna preferred provider list is available online through Doc Find, searchable by provider type, condition, procedure, name and location.
- Call the Weill Cornell Referral Center (pdf) Monday-Friday 9 a.m.-5 p.m. at 646-962-2000 or search their online “Find a Physician” database, filterable by specialty, name, insurance and more. More than 85 percent of Weill physicians are available through Aetna’s nationwide network of providers. The Weill Cornell Referral Center can help you find the right physician, within your coverage, for your specific needs.
Contract College Faculty, staff and covered dependents on the Empire Plan
The NYSHIP Empire Plan currently offers Centers of Excellence for cancer, transplants and infertility services. Paid-in-full benefits are available for services at a designated Center of Excellence when using these providers and calling in advance for preauthorization. If you do not use a Center of Excellence, benefits are provided in accordance with the plan’s Hospital Program and/or Medical/Surgical Program coverage.
In some cases, a travel, lodging and meal allowance may be available.
Center of Excellence listings are available by calling NYSHIP.
Where to start
Call The Empire Plan toll free at 1-877-7-NYSHIP (1-877-769-7447) and follow the prompts to the appropriate program outlined below. A representative will then provide you with coverage details such as preauthorization requirements and the most up-to-date listing of the Centers of Excellence that pertain to your needs
- United Health Care Medical Program: home care services, out-patient chemotherapy, cancer or infertility
- Blue Cross, Blue Shield Hospital Program: transplants
- Beacon Health Mental and Substance Abuse Program
- CVS Caremark: prescription drug benefits and claims
Benefit details available online
Visit the NYSHIP Health Benefits website for an overarching view of your benefits and coverage:
- Select “I am a New York State Active Employee”
- Choose “Management/Confidential (M/C); Legislature” as your Group
- Select either “Empire Plan Enrollee” OR “HMO Enrollee”
Browse At a Glance for an overview of the plan.
Then review the Certificate of insurance for specifics regarding preauthorization, coverage and travel allowances
You can also visit UnitedHealthcare’s myuhc.com for additional details related to the Medical Program, including eligibility, deductibles, out-of-pocket limits, and a Center of Excellence (COE) listing. COE’s can be found by:
- Logging in
- Selecting “Benefits & Coverage”
- “Extra Programs”
- “Centers of Excellence Networks”
Online Provider directories
- The Empire Plan provider directory is available online, and filterable by specialty, location, conditions, procedures and name. Note that although the Centers of Excellence physicians will be listed, you cannot search by this option.
- Call the Weill Cornell Referral Center (pdf) Monday-Friday 9 a.m.-5 p.m. at 646-962-2000 or visit their online “Find a Physician” database, filterable by specialty, name, insurance and more. More than 85 percent of Weill physicians are available through Aetna’s nationwide network of providers – they can help you find the right physician, within your coverage, for your specific needs.
Contract College faculty, staff, covered dependents, and retirees in HMOs
Individuals covered under an HMO should contact their HMO for specific questions about coverage. The 2016 Choices Booklet and 2017 Choices Booklet provide summary information on the HMO Plans and the Empire Plan including contact information.
Retiree Endowed faculty, staff and covered dependents
Individual coverage may vary depending on which of our three retiree plans you are enrolled in. Refer to the owners manual you received by mail or the back of your Aetna ID card for your appropriate member services phone number, or log onto your secure Aetna member account.
Retiree Contract College faculty, staff and covered dependents
Contact Benefit Services at 607-255-3936 or firstname.lastname@example.org , or call your plan administrator.
Empire Plan retirees
Call NYSHIP at 1-877-769-7447 or visit the NYSHIP Retirees Health Benefits website for an overarching view of your benefits and coverage. Select “A Participating Agency (PA) with the Empire Plan."