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The 1199 Health Insurance Plan is a private medical insurance option that offers comprehensive healthcare services to its members. It is accepted by many healthcare providers, including Heart and Health Medical, which offers care in cardiology, primary care, internal medicine, and podiatry. The insurance plan provides access to a wide range of benefits, including medical, dental, prescription, and vision coverage, with little to no co-pay and low premiums. Members of the 1199SEIU Benefit Funds have access to a network of over 30,000 providers and are covered for a variety of services, including primary care, specialty care, outpatient laboratory and radiology, emergency care, hospitalization, and ambulatory care procedures.
| Characteristics | Values |
|---|---|
| Name | 1199 Health Insurance Plan |
| Provider | 1199SEIU Benefit Funds |
| Coverage | Medical, Dental, Prescription, Vision, Behavioral and Mental Health |
| Co-pay | Little or no co-pay |
| Premiums | Low premiums |
| Service Access | Over 30,000 providers in New York City, Westchester and Long Island |
| Service Types | Comprehensive primary care, specialty care, outpatient laboratory and radiology, emergency care, hospitalization, and ambulatory care procedures |
| Prescription Drugs | Covered if in accordance with the 1199SEIU Benefit Funds' Preferred Drug List |
| Non-covered Services | Services not included in the member's SPD |
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What You'll Learn
- The 1199 Health Insurance Plan is accepted by Heart and Health Medical
- Members are covered for drugs prescribed in accordance with the 1199SEIU Benefit Funds' Preferred Drug List
- The 1199 Health Insurance Plan offers little or no co-pay and low premiums in exchange for high-quality care
- The 1199SEIU Benefit Funds cover comprehensive primary care, specialty care, outpatient laboratory and radiology, emergency care, hospitalization, and ambulatory care procedures
- The 1199SEIU Benefit Funds do not cover services related to an illness or injury where payment is the legal responsibility of another insurance company
The 1199 Health Insurance Plan is accepted by Heart and Health Medical
Heart and Health Medical is a leading provider of cardiology, primary care, internal medicine, and podiatry services. The organisation has three locations in Long Island and is recognised for providing state-of-the-art medical care. The cardiologists at Heart and Health Medical, including Dr. David Kavesteen and Dr. Anthony Spera, are highly regarded in their field. Dr. Kavesteen, the founder of Heart and Health Medical, has received numerous accolades, including being recognised as a "Leading Physician of the World" and "Top Cardiologist in Babylon, NY" by the International Association of Cardiologists.
The 1199 Health Insurance Plan provides comprehensive coverage for its members, including medical, dental, prescription, and vision care. The specific benefits and coverage may vary depending on the particular plan chosen, as there are different options within the 1199 Health Insurance Plan. However, members can rest assured that they will have access to a wide range of healthcare services through the 1199SEIU Benefit Funds.
These benefit funds provide coverage for comprehensive primary care, specialty care, outpatient laboratory and radiology services, emergency care, hospitalization, and ambulatory care procedures. Additionally, the 1199 Health Insurance Plan covers prescribed drugs in accordance with the 1199SEIU Benefit Funds' Preferred Drug List. This ensures that members have access to the medications they need through the Benefit Funds' custom participating pharmacy network.
It is important to note that there are also “non-covered services" that are not payable by the 1199SEIU Benefit Funds. Before providing these services, providers must notify members in writing and specify the associated costs. Therefore, members should always refer to their specific plan's details to understand the included and excluded services. Overall, the acceptance of the 1199 Health Insurance Plan by Heart and Health Medical ensures that individuals with this insurance plan can access the high-quality medical services provided by their team of renowned cardiologists and other specialists.
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Members are covered for drugs prescribed in accordance with the 1199SEIU Benefit Funds' Preferred Drug List
The 1199SEIU Benefit Funds Preferred Drug List is a list of drugs that are covered by the 1199SEIU health insurance plan. This drug list is subject to change at any time between quarterly updates. Members are advised to check the latest list before seeking treatment. The 1199SEIU health insurance plan is one of the best healthcare plans available, offering little to no co-pay and low premiums in exchange for high-quality care.
The Preferred Drug List offers members a range of generic and preferred brand-name drugs, helping them to avoid out-of-pocket costs. This list can be accessed via the 1199SEIU website, which also provides members with a network of over 30,000 healthcare providers across New York City, Westchester, and Long Island.
For those living outside these areas, the choice of providers extends to the Aetna Choice POS II network, with no referrals or out-of-pocket costs for covered services. It is important to note that members should always check if their chosen provider is part of the Benefit Fund's network to avoid unexpected expenses.
The 1199SEIU health insurance plan covers a wide range of medical services, including cardiology, primary care, internal medicine, and podiatry. Additionally, members can access mental and behavioural health services, as well as specialty drug lists for specific conditions. Prior authorization for drug treatments is required, and providers must use the ExpressPAth platform for this purpose.
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The 1199 Health Insurance Plan offers little or no co-pay and low premiums in exchange for high-quality care
The 1199 Health Insurance Plan is a fantastic option for those seeking quality healthcare at an affordable price. One of the most attractive features of this plan is the minimal to no co-pay, meaning you won't have to worry about hefty out-of-pocket expenses when seeking medical care. This is especially beneficial for those who require frequent medical attention or are concerned about unexpected costs. With the 1199 Health Insurance Plan, you can rest assured that your healthcare needs are covered without breaking the bank.
In addition to the low co-pay, the 1199 Health Insurance Plan also boasts low premiums. This means that the ongoing cost of maintaining this insurance plan is relatively inexpensive compared to other options on the market. This is ideal for those who want to prioritize their health without sacrificing their financial stability. By offering low premiums, the 1199 Health Insurance Plan makes it feasible for individuals and families to access high-quality healthcare consistently.
What truly sets the 1199 Health Insurance Plan apart is the commitment to providing high-quality care. This plan ensures that members have access to a wide range of medical services, including cardiology, primary care, internal medicine, and podiatry. The network of healthcare providers associated with this plan are renowned experts in their respective fields, ensuring that members receive the best possible treatment. This includes renowned cardiologists like Dr. David Kavesteen, recognized as a "Leading Physician of the World" and awarded for his exceptional patient care.
The 1199 Health Insurance Plan also offers a comprehensive range of benefits, including medical, dental, prescription, and vision coverage. This means that members can take care of their overall health and well-being without worrying about the financial burden. The plan also provides access to behavioral and mental health services, demonstrating a holistic approach to healthcare. With the 1199 Health Insurance Plan, members can have peace of mind knowing that their physical and mental health needs are equally prioritized.
Furthermore, the 1199 Health Insurance Plan provides flexibility and convenience through its network of Benefit Fund providers. Members can access more than 30,000 providers throughout New York City, Westchester, and Long Island, ensuring they can find the right healthcare professional close to home. This extensive network also includes affiliated network hospitals, making it convenient to receive specialized care when needed. The plan also offers the option to choose providers from the Aetna Choice POS II network for those living outside the designated areas.
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The 1199SEIU Benefit Funds cover comprehensive primary care, specialty care, outpatient laboratory and radiology, emergency care, hospitalization, and ambulatory care procedures
The 1199SEIU Benefit Funds provide access to a comprehensive range of healthcare services, ensuring members can maintain their health and well-being. The coverage includes essential primary care, offering a foundational level of support for members' overall health. This primary care serves as a gateway to other medical services, facilitating timely access to specialists and ensuring holistic health management.
The 1199SEIU Benefit Funds also cover specialty care, recognising that members may require specialised medical attention at some point. This coverage extends to a wide range of medical specialities, ensuring that members can access the specific care they need. For instance, members can seek cardiology services from renowned cardiologists like David Kavesteen, MD FACC, and Anthony Spera, MD FACC, at Heart and Health Medical, a provider that accepts the 1199 Health Insurance Plan.
In addition to physician-led services, the 1199SEIU Benefit Funds cover outpatient laboratory and radiology services. This coverage ensures that members can access necessary diagnostic procedures without financial barriers, facilitating early detection and timely treatment.
Moreover, the 1199SEIU Benefit Funds recognise the importance of emergency care and hospitalisation coverage. This aspect of the plan provides members with peace of mind, knowing that unexpected medical events are covered. Whether it's an unforeseen accident, a sudden illness, or a planned hospital stay, members can focus on their recovery without the added stress of financial worries.
Lastly, the 1199SEIU Benefit Funds cover ambulatory care procedures, which are medical procedures that do not require an overnight hospital stay. This coverage promotes convenience and accessibility, allowing members to undergo necessary procedures without the need for hospitalisation, thus minimising disruption to their daily lives. Overall, the comprehensive nature of the 1199SEIU Benefit Funds ensures that members have access to a wide range of healthcare services, supporting their health and well-being at every step.
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The 1199SEIU Benefit Funds do not cover services related to an illness or injury where payment is the legal responsibility of another insurance company
The 1199SEIU Benefit Funds provide comprehensive primary care, specialty care, outpatient laboratory and radiology, emergency care, hospitalization, and ambulatory care procedures. The 1199SEIU Benefit Funds also cover medical, dental, prescription, and vision healthcare. However, it is important to note that the 1199SEIU Benefit Funds do not cover all services and charges.
There are certain services that are considered "non-covered" and are not payable by the 1199SEIU Benefit Funds. This includes services related to an illness or injury where the payment for these services is the legal responsibility of another entity, such as an insurance company or another person. For example, if an illness or injury resulted from the conduct of another person, the charges for these services would not be covered by the 1199SEIU Benefit Funds as the payment would be the responsibility of another party.
Other examples of non-covered services include charges for services that are not medically necessary, charges related to interest or late fees, and charges for certain programs such as smoking cessation or weight reduction that are not provided by a licensed medical physician. It is important for providers to verify a member's eligibility before providing non-emergency covered services, as eligibility may change from month to month.
If a member is referred to a non-participating provider, they may face high out-of-pocket costs. To avoid unexpected costs, members should always check that their provider is part of the Benefit Fund's network.
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Frequently asked questions
The 1199 Health Insurance Plan is one of the best healthcare plans available. It offers little to no co-pay and low premiums in exchange for high-quality care. The plan covers medical, dental, prescription, and vision healthcare.
The 1199 Health Insurance Plan covers comprehensive primary care, speciality care, outpatient laboratory and radiology, emergency care, hospitalization, and ambulatory care procedures. It also includes behavioural and mental health coverage.
The 1199SEIU Benefit Funds' Preferred Drug List covers drugs prescribed to members. All prescriptions must be submitted electronically and can be collected from any participating pharmacy.
"Covered services" are medically necessary services payable by the 1199SEIU Benefit Funds. "Non-covered services" are services not included in a member's SPD and are not payable by the 1199SEIU Benefit Funds.
