Healthy NY

Healthy NY Benefit Package
Services Covered by Healthy NY

Adult preventive services consisting of mammogram, Pap test, prostate cancer screening, physical examinations every three years and adult immunizations

Preventive and primary health care services for dependent children including routine well-child visits and immunizations

Inpatient hospital services consisting of daily room and board, general nursing care, special diets and miscellaneous hospital services and supplies

Outpatient hospital services consisting of diagnostic and treatment services

Physician services consisting of diagnostic and treatment services, consultant and referral services, surgical services (including breast reconstruction surgery after a mastectomy), anesthesia services, second surgical opinion and a second opinion for cancer treatment

Emergency services

Outpatient surgical facility charges related to a covered surgical procedure

Diagnostic, x-ray, and laboratory services

Pre-admission testing

Maternity care

Home health care (up to 40 post-hospital or post-surgical visits per calendar year)

Physical therapy (up to 30 post-hospital or post-surgical visits per calendar)

Diabetes equipment, supplies and self-management education

Therapeutic services including radiological services, chemotherapy and hemodialysis

Blood and blood products furnished in connection with surgery or inpatient hospital services

If the prescription drug benefit is selected, prescription drugs obtained at a participating pharmacy

In order to qualify for Healthy NY, your household income must fall within the limits set by law.

Each Additional Person Add $825 Pregnant women count as two people. Income levels are updated annually.

Deductible
All plans are subject to an annual deductible. The deductible amount is the amount you must spend out-of-pocket before services are covered. Preventive care can be accessed prior to meeting the deductible. For 2012, the deductible is $1,200 for individuals and $2,400 for families. The deductible amount may change annually.