Voluntary Hospitals House Staff Benefits Plan

(VHHSBP)

Effective January 1, 2006
IN NETWORK If you elect to go with Empire Point of Service In-Network Plan, you get comprehensive, quality benefits to meet all your healthcare needs. Empire will provide you with customer-centered healthcare including such benefits as doctors’ office visits, preventive care including well-child and well-woman services, emergency care, maternity care and hospitalization coverage.
Access to Doctors Unrestricted. You can see any licensed Primary Care Physician (PCP) within the Empire POS network. Empire’s tri-state network of physicians has more than 64,000 providers.
Referrals Not necessary. You control your own healthcare
Co-payment $20 co-payment for physician office visits.$25 co-payment for mental health visits (30 visits per plan year.)$35 co-payment for ER visits only if you are not admitted to hospital.There is no deductible when seeing an in-network provider. 
International Coverage Available for emergencies. You have the option of seeing any doctor or hospital for emergency care. Subject to out-of-network deductible and co-insurance. There is no change from the current plan.
National Coverage Covered. Wherever you live, work or travel within the U.S., Empire’s POS plan provides access to medical professionals. Medical services rendered outside of the local POS network as subject to out-of-network deductible and co-insurance.
Prescription Drug Payments $5 co-payments for generic drugs$15 co-payment for brand name drugs$30 co-payments for non-formulary drugs.
Full Coverage after $20 Co-payment  Annual physical exams for adults; lab tests and X-rays; physical, occupational, speech, and vision therapies; durable medical equipment, prosthetics and orthotics; skilled nursing facility care; home infusion therapy; MRI exams hospice care.
EMPIRE Health Line To get immediate assistance 24/7, call Empire Help Line:  877-TALK-2-RN.  To be sure that you are eligible for in-network benefits, and to verify that your medical professional or hospital participates with the Empire Blue Cross/Blue Shield POS network, call 800-553-9603.
EMPIRE Website www.empireblue.com
OUT-OF-NETWORK There is no change in the maximum out-of-pocket provision or deductibles.
Deductible $100 single; $200 family (United Healthcare deductibles will be carried over if they have already been met (first year only).
Co-Insurance Plan pays 80% of reasonable and customary costs. You are responsible for your deductible and co-insurance. You may be required to pay in full and then submit a claim form to Empire.
Out-of-Pocket Maximum $500. When the 20% co-insurance for Major Medical Benefits, including the deductible, reaches $500 for any person in a Plan Year, benefits will be paid a t 100% of reasonable and customary charges for that person for the remainder of the Plan Year (July 1 through June 30). In-network co-payments do not count towards the $500 out-of-pocket maximum.
International Coverage Available for emergencies. You have the option of seeing any doctor or hospital for emergency care. Subject to out-network deductible and co-insurance. There is no change from the current plan.
Co-Payment Member pays $35 co-pay for ER visits only if you are not admitted to hospital.
Mental Health Plan pays 50% of the reasonable and customary charges; visits for each person each Plan Year.Prescription drug payments.
Prescription Drug Payments $5   co-payments for generic drugs
$15  co-payments for band name drugs
$30 co-payments for non-formulary drugs
EMPIRE Website www.empireblue.com

Contact the Program

The Brookdale University Hospital and Medical Center

One Brookdale Plaza

Brooklyn, NY 11212

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