Insurance Information

Aetna

Hospital for Special Surgery is an in-network provider with Aetna's HMO, POS, EPO and PPO plans with the following exceptions:

• Hospital for Special Surgery is NOT an in-network provider for Aetna's Medicare Managed Care/Advantage plans.

Affinity Health Plan

Hospital for Special Surgery is participating with Affinity for their Managed Medicaid HMO, Child Health Plus (CHP) and Family Health Plus (FHP) plans.

Blue Cross Blue Shield - Empire

Hospital for Special Surgery is an in-network provider with Empire Blue Cross Blue Shield’s HMO, POS, Child Health Plus (CHP), Healthy New York (HNY), PPO, EPO and Indemnity (or Traditional) plans with the following exceptions:

• Hospital for Special Surgery is NOT an in-network provider for Empire's Medicare Managed/Advantage and Medicaid Managed Care plans.
• New York City Employee Health Insurance Plan
  Hospital for Special Surgery is an in-network provider for New York City employees who have health insurance under New York City's Comprehensive Benefits Plan provided by Empire Blue Cross Blue Shield PPO. Please note: Empire Blue Cross Blue Shield covers your inpatient and outpatient surgical services under this plan. All other services, such as outpatient diagnostic services (x-ray, laboratory, etc.) and physician services are provided under your GHI plan. Hospital for Special Surgery is NOT an in-network provider with GHI.
• New York State Employee Health Insurance Plan (NYSHIP or the Empire Plan)
  Hospital for Special Surgery is an in-network provider for New York State employees covered by the “Empire Plan”. Please note: Empire Blue Cross Blue Shield covers only your inpatient and outpatient hospital services under this plan. United Healthcare provides the network of physicians. Not all United Healthcare in-network physicians participate with the Empire Plan.

Blue Cross Blue Shield - Out-of-Area

Some, but not all, out-of-area Blue Cross Blue Shield plans include Hospital for Special Surgery as an in-network provider through the National PPO BlueCard^® Program. The BlueCard^® program allows you to access in-network benefits from other local Blue Cross PPO plans and all authorized and covered services provided by the hospital would be subject to your in-network deductibles and coinsurance levels. The existence of the “PPO in a suitcase logo” on your member identification card typically confirms your plan’s participation in the BlueCard^® program.

• UniCare Affiliated PPO
  Members of the UniCare Affiliated PPO plans have in-network access to Hospital for Special Surgery through an affiliation with Empire Blue Cross Blue Shield.

CIGNA

Hospital for Special Surgery is an in-network provider with CIGNA's HMO, POS, EPO and PPO plans with the following exceptions:

• Hospital for Special Surgery is NOT an in-network provider for CIGNA's Medicare Managed Care/Advantage plans.

Health Net

Hospital for Special Surgery is an in-network provider with Health Net's HMO, POS, EPO and PPO plans with the following exceptions:

• Hospital for Special Surgery is NOT an in-network provider for Health Net's Medicare Managed Care/Advantage plans.

Medicaid

Hospital for Special Surgery is participating with Traditional New York State Medicaid insurance. You are responsible for any co-payments. If you are enrolled in a Medicaid Managed Care HMO, Child Health Plus and Family Health Plus plan your benefits and coverage at Hospital for Special Surgery may be limited. Please contact VOICES Medicaid Managed Care Education Program at 212.774.2011 to determine your options at Hospital for Special Surgery.

Medicare

Hospital for Special Surgery is participating with Traditional Medicare insurance. You are responsible for co-insurance and deductible costs. If you are enrolled in a Medicare Managed Care/Advantage plan, the benefits and coverage at Hospital for Special Surgery may be limited. For further information please call the HSS Insurance Advisory Service at 212.774.2607 or email your question through our online form.

Multiplan/PHCS

Hospital for Special Surgery is a participating provider with Multiplan/PHCS. In-network status depends upon your policy's plan. Please call your plan’s customer service phone number to determine if the services of the Hospital will be considered in-network.

Neighborhood Health Providers (NHP)

Hospital for Special Surgery is participating with NHP for their Managed Medicaid HMO, Child Health Plus (CHP) and Family Health Plus (FHP) plans.

No-Fault

Hospital for Special Surgery accepts No-Fault Insurance. You must have a valid case/claim number and authorization (if applicable) prior to seeking care at HSS.

Oxford Health Plans

Hospital for Special Surgery is an in-network provider with Oxford's Freedom, Liberty, and Medicare Managed Care/Advantage plans.

United Healthcare

Hospital for Special Surgery is an in-network provider with United Healthcare's HMO, POS and PPO plans.

Note: United Healthcare's Medicare Managed Care/Advantage plans do NOT include Hospital for Special Surgery as an in-network provider.

Workers' Compensation

Hospital for Special Surgery accepts Workers' Compensation. You must have a valid case/claim number and authorization (if applicable) prior to seeking care at HSS.