HIP Health Plan

Important Information Regarding HIP Health Insurance

Today, HIP Health Plan is the largest HMO provider servicing customers in the New York City area. More than 160 hospitals, including acute care centers, are affiliated with the HIP Health Plan network in the tri-state area of New York, Connecticut and Massachusetts.

HIP Health Plan consists of an enormous network of healthcare professionals who are specifically contracted with HIP Health. Policyholders have access to these same medical professionals who practice in large, multi-specialty outpatient medical centers. These medical centers are associated with some of New York City’s most prestigious hospitals, including Beth Israel Medical Center, Lenox Hill Hospital, St. Luke’s- Roosevelt Hospital Center, St. Barnabas Medical Center and Montefiore Medical Center. Many private physicians who work from their own personal offices are also affiliated with the HIP network of providers.

The HIP network is made up of nearly 43,000 physicians and healthcare professionals. The network also has more than 72,000 medical facilities located throughout New York, Connecticut and Massachusetts. In 2001, HIP acquired Vytra Health Plans and in 2005, Connecticare, one of the largest health insurance providers in Connecticut. Today, HIP Health Plan has a total membership of nearly 1.5 million.


A Summary of HIP Health Plans

HIP Health Plan offers its customers several different plans from which to choose their health insurance packages. HIP Prime is an HMO plan which provides comprehensive coverage within an ever-increasing network of healthcare professionals. HIP Prime delivers low monthly premiums to its policyholders as well as access to a large provider network of physicians and specialists. Discounts on value added services are also available under this HMO plan.

HIP Access is another popular choice for health insurance coverage which is offered by HIP Health Plan. This plan provides benefits above and beyond the normal HMO plans, including the elimination of a referral to seek treatment from another physician. Policyholders with the HIP Access plan can choose from a network of over 25,000 physicians and specialists, practicing in over 40,000 locations, including some of the finest hospitals and medical groups in New York. HIP Access has no annual deductible and no co-insurance requirement. Most in-network services are fully covered, after the co-payment is satisfied.

HIP Classic provides quality, affordable health insurance tailored to meet the needs of small groups and businesses. It includes a structured tier rate which allows business owners to choose group coverage that best suits their company’s needs and circumstances. HIP Classic offers its members access to a large network of physicians and specialists, including medical groups associated with New York’s top hospitals. For a routine visit to a primary care physician, the cost can be as low as a $15 co-payment. For most in-network services, coverage is 100%, after the co-payment.

The HIP Health Plan Plus Direct program is a New York State Point of Service (POS) option that is only offered to direct pay eligible individuals who purchase their health insurance policies directly from HIP Health Plan, not through an employer-sponsored health plan. This plan offers co-payments when using in-network physicians and treatment facilities. Policyholders are allowed to use non-network service providers, but are responsible for any co-insurance and deductible amounts.

HIP Health Plan Choice Plus Direct offers coverage for prescription drugs (with an annual deductible) when they are prescribed by a network healthcare professional. Out-of-network prescription drug coverage is not available under this plan.

Members of the HIP Health Plan Choice Plus Direct program have a lifetime maximum out-of-pocket expense limit that they are allowed to claim. Policyholders can select from a network of independent physicians and also can seek treatment from multi-specialty medical groups.


Competing Carriers

Health Net
Medical Mutual


HIP Health Insurance Quotes Are Available In New York


HIP & GHI Agree To Merge To Create Largest Health Insurer in New York State