Mount Sinai South Nassau Participating Insurance Plans

At Mount Sinai South Nassau, we participate in Medicare, Medicaid and most HMOs and commercial insurance plans.

If you are not sure if we participate with your insurer, please call your insurer for confirmation — and for any special considerations. For example, most patients are required to obtain their laboratory and radiology services at a dedicated facility. Please note that hospital-employed physicians may accept many, but not all, of the plans that the hospital accepts. You must check with your physician before treatment to determine the insurance plans s/he accepts.

Note that a physician’s or hospital’s participation with an insurance plan does not automatically mean that your plan will cover every expense; always check with your insurance company before undergoing any diagnostic procedure (such as a lab test or radiology) to ensure that the physician, lab or facility participates in your plan; that the test is a covered expense; and what portion of the diagnostic expense you will be responsible for.  Diagnostic facilities can often have separate co-payment requirements, and some insurance companies may require you to have outpatient laboratory services performed at their designated facilities. Your insurer may require you to pay for any services provided that are not covered by your contract. Please click here to read important information about paying for your care at Mount Sinai South Nassau. If you will be having laboratory tests performed at Mount Sinai South Nassau, you can check the listing of our lab’s participating insurance companies here.

If you do not have insurance, or are unable to pay for the hospital services provided, our Financial Assistance Program may be able to help.

Mount Sinai South Nassau's participating plans:

•  AgeWell — Medicare
  
• Aetna/US Health Care — all HMO, PPO, Self-Insured Plans, Aetna Signature Administrators, Indemnity, Medicare HMO and PPO
  
• Affinity — all lines of business, including the Health Exchange Plan
  
• AlphaCare — Nassau County only
  
• Beacon Behavioral Health
  
• Beech Street — PPO
  
• Blue Cross/Blue Shield (Empire)
  • Empire MediBlue Medicare Advantage Plans
  • Commerical HMO, PPO, & Indemnity Plans
    
  • “The Empire Plan” New York State Employees and Participating Agencies (NOTE: United Health Care Insurance Company of New York provides Medical coverage)
  • The City of New York Plan (NOTE: GHI provides Medical coverage)
  • BlueCross/BlueShield Federal Employee Program
  • Empire BlueCross BlueShield HealthPlus
• Centivo
• CenterLight (formerly CCM)
  
• ChoiceCare (Humana)
  
• Cigna Health Care (Connecticut General)
  
• CorVel — WC only
  
• Coventry/First Health/CCN Network — PPO
  
• Elderplan
  
• Fidelis Health — Medicaid, Child Health Plus HMO Plans and the Health Exchange Plan
  
• Galaxy/MCI — PPO
  
• GHI (Group Health Incorporated) — all Commercial, HMO, HMO Select, PPO, Flex, GHI-BMP, Medicare HMO and Self-Insured Plans
  
• Healthfirst — All Plans
  
• HIP (Health Insurance Plan of New York) — Medicare, Medicare HMO Plans and Medicaid HMO
  • All Commercial HMO, PPO and Self-Insured Plans
    
• Hospice Care Network
  
• Hospice of New York (Inpatient Hospice Care Only) — specific to Hospice Care Network patients
• Humana — ChoiceCare, Gold Plus HMO, Choice PPO, Gold Choice
  
• Island Group Administration — PPO out of Southampton
  
• MagnaCare Preferred, Inc. — all PPO, Direct Plus-MagnaCare, HMO and Self-Insured Plans
  
• Magellan Behavioral Health (formerly Merit Behavioral Care) — Mental Health only
  • All HMO, PPO and Self-Insured Plans
    
• Medicare
  
• Medicaid
  
• MetraComp — Workers Compensation only
  
• Metropolitan Jewish Hospice
  
• Multiplan — All HMO, PPO and Self-Insured Plans
  
• NYSHIP (the Empire Plan)
  
• Oscar Insurance Corporation — Health Exchange Plan
  
• Oxford Health Plans — HMO (Freedom), PPO (Liberty) and Self-Insured Plans, Medicare Advantage, Commercial (except OXFORD HEALTH EXCHANGE and OXFORD METRO)
  
• Partners Health Plan — Medicare Managed Care and Medicaid Managed Care
  
• Private Healthcare Systems, Inc. (PHCS) — All PPO and Self-Insured Plans
  
• Senior Whole Health — Medicare/Medicaid dual eligible
  
• Three Rivers Health Plans — PPO
  
• United Behavioral Health — All hospital-based services (inpatient and partial hospitalization)
  
• United Health Care of New York, Inc.
  • HMO, PPO, Self-Insured Plans and Medicare HMO, Commercial
  • NON PAR WITH — UnitedHealthcare Community Plan, Medicaid HMO, Child Health Plus Plans, United Dual Complete, Compass, UNITED HEALTHCARE EXCHANGE, UNITED HEALTH CORE/CHARTER
    
• USFHP (US Family Health Plan) — Military
• Value Behavioral Health (ValueOptions) — Mental Health
  • All HMO, PPO and Self-Insured Plans
    
• VNSNY Choice — Medicare, Medicaid lines of business
  
• Vytra Health Plans - All Commercial, HMO, PPO and Self-Insured Plans
• WellCare Medicare and WellCare Medicaid
  
• Zadroga Plan for 9/11 Victims (HealthSmart)
  

Medicare

If you have Medicare, you must complete the Medicare Secondary Payor Questionnaire. For your convenience, we suggest that you print out the questionnaire, complete it and bring it with you to the hospital. You may qualify for Medicare benefits if you:

• Are 65 or older
• Are permanently disabled
• Have end-stage renal disease

Your Medicare card will indicate if you have Part A benefits, Part B benefits or both, and their effective dates.

Medicare Part A provides benefits for:

• Inpatient hospitalization
• Skilled nursing services
• Hospice care
• Certain home health care services

Medicare Part B provides benefits for:

• Ambulatory surgery services
• Emergency room services
• Clinic services
• Referred ambulatory services
• Physician services

Medicare Part B beneficiaries who receive hospital outpatient care will be responsible for a predetermined co-payment for each covered procedure or test.

If you have a specific question about your Medicare benefits, call Empire Medicare, toll-free: (800) 442-8430 or go to empireblue.com.

Medicaid

Medicaid is a state-run health care program for patients not covered by other health care insurance. Eligibility is determined by criteria such as earnings and family size. 

Medicaid covers almost all aspects of health care, although some services are subject to patient copay amounts ranging from $0.50 to $25.

If you believe you may be eligible for Medicaid, apply at your local office of the Department of Social Service (links to another website).

If you are seeking assistance for inpatient services, Mount Sinai South Nassau’s Financial Assistance professionals may be able to help you complete your application.

Uninsured
If you do not have insurance, please call our Financial Assistance professionals at (516) 632-3979 to see if you qualify for Medicaid, Child Health Plus or the hospital Financial Assistance Program.