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Group Health Incorporated (GHI)

Group Health Incorporated (GHI) was founded in 1937 as Group Health Association of New York, a small health cooperative with only a few subscribers and considerably less premiums. Since then, Group Health Association of New York has come to be called as Cooperative Health Association of New York, Group Health Cooperative, Group Health Insurance and, since 1971, Group Health Incorporated. At present GHI is the biggest not-for-profit health insurer in New York State, serving more than 2.6 million individuals. GHI is the pioneer of several health insurance programs that are standard today. In the United States, it was the first health services corporation selected as the single nationwide administrator for Coordination of Benefits (COB) for Medicare. In New York State, among many firsts, GHI was the first to offer paid-in-full benefits regardless of patient income; first to cover preventive medicine, such as annual physical exams and well-baby care; first to cover in-hospital medical care; first independent voluntary health insurance carrier designated by the Social Security Administration to function as a Medicare Part B carrier; and first to include an Employee Assistance Program (EAP) benefit for small groups.

The company offers a wide variety of medical, hospital, dental, mental health, vision and prescription drug plans for its subscribers. Some of these plans are:

GHI Alliance Value Plan: This plan covers basic hospital, medical and prescription drug. A subscriber can receive in-network treatment from any of the 89,000 providers in the GHI PPO structure, and also enjoy benefit for out-of-network services. One requires no referrals, and several cost-saving options are available.

GHI Alliance 365 Day Hospital Plan: It is an inexpensive plan that offers inpatient and outpatient hospital benefits, protecting you from high hospital costs while keeping your monthly out-of-pocket expenses under control. Its coverage includes most out-of-network hospital services, as well as most hospital facility charges, with no deductible nor coinsurance.

GHI Small Business Advantage Plan: With this program, you can have access to over 127,000 provider locations and more than 56,000 participating pharmacies. You do not need any referral either and can consult any provider in the GHI network.

Healthy New York EPO: It offers complete hopsital, medical and prescription drug coverage. You can visit any provider in the GHI network without a referral, and enjoy treatment at over 127,000 locations. This plan is only available to members in the following areas: Bronx, Kings (Brooklyn), Nassau, New York City (Manhattan), Queens, Richmond, Rockland, Suffolk and Westchester.

Direct Pay GHI HMO: With this HMO, you can benefit from complete hospital, medical and prescription drug coverage within the GHI HMO network of over 40,000 provider locations. It offers several services from preventative care to emergency treatment and wellness visits. It also gives you some cost-saving options are available to suit your personal needs.

Direct Pay POS: It gives you the same strength of coverage as are available in the Direct Pay GHI HMO. In addition, it provides you access to out-of-network benefit. POS plans incorporate HMO and PPO coverage with the expanded freedom of treatment outside the GHI network.

Medicare plans offered by GHI are GHI Medicare Choice PPO, GHI Medicare Prescription Drug Plan, and Medicare Supplement Insurance. It also offers for low- income people plans like Child Health Plus, Family Health Plus and Medicaid Managed Care.




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