Ghi Private Insurance: What You Need To Know

GHI stands for Group Health Incorporated (GHI), which was established in 1937 to provide New York's working families with access to medical services. In 2006, GHI merged with the Health Insurance Plan of Greater New York (HIP) to form EmblemHealth, one of the largest non-profit health plans in the United States. Today, EmblemHealth offers a range of health insurance plans, including the GHI Comprehensive Benefits Plan (CBP), which allows members to choose in-network or out-of-network doctors with flexible coverage and low copays. GHI International also provides worldwide personalized health insurance with a focus on easy access to healthcare and swift claims processing.

GHI Comprehensive Benefits Plan (CBP)

The GHI Comprehensive Benefits Plan (CBP) is a health insurance plan offered by EmblemHealth, one of the largest non-profit health plans in the United States. EmblemHealth was formed in 2006 through the merger of Group Health Incorporated (GHI) and the Health Insurance Plan of Greater New York (HIP).

The GHI CBP plan offers flexible coverage, allowing members to choose in-network or out-of-network doctors without a referral. When seeing a network doctor, members typically only pay a copay, while using an out-of-network doctor may result in substantial out-of-pocket expenses. The plan covers medical and surgical services, and hospitalization benefits are provided by Anthem Blue Cross and Blue Shield.

GHI CBP offers low copays for in-network services, with $0 copay for AdvantageCare Physicians (ACPNY) providers, $15 copay for All Other PCPs, and $30 copay for all other specialty providers. For diagnostic/lab services, the copay is $20, while for MRI/CAT/High-Tech Radiology, it is $50 for participating facilities. Physical therapy has a $20 copay, and an emergency room visit will cost $150.

The plan also has a Maximum Out-of-Pocket (MOOP) limit, which refers to the maximum amount of in-network cost-sharing expenses that members will pay in a calendar year for covered services. This amount may change from year to year and includes deductibles, coinsurance, and copay charges.

Overall, the GHI Comprehensive Benefits Plan provides members with flexible coverage options, a wide range of in-network and out-of-network doctors, and access to quality healthcare services with manageable copayments and out-of-pocket expenses.

GHI Select HMO

The GHI Select HMO plan offers a wide range of covered services from network doctors and hospitals for a small copay. With this plan, you can choose a regular doctor who will manage and oversee your care, including administering referrals to network specialists and arranging hospital stays if needed. GHI Select HMO is available to active employees and non-Medicare-eligible retirees living in New York City and several New York State counties, including Albany, Nassau, Rockland, and more.

The GHI HMO Medicare Senior Supplement plan is also available, covering the same services for Medicare-eligible retirees. This plan includes coverage for deductibles, coinsurance, and services not covered by Medicare Parts A and B. You can further enhance your GHI HMO plan with Medicare Part D benefits for prescriptions received at network pharmacies and through home delivery service.

In terms of costs, GHI HMO offers $0 copays at AdvantageCare Physicians providers or Montefiore faculty-based centres. Routine visits to a primary care physician (PCP) or specialist typically incur a $15 copay, while diagnostic labs have a $0 copay, and routine physical exams have a $15 copay. Outpatient mental health services are also covered with a $15 copay, and urgent care visits typically cost $15. Ambulance surgery has no associated cost, while an emergency room visit has a $35 copay, which is waived if the patient is admitted.

You can add prescription drug coverage for generic and brand-name drugs from network retail drug stores and home delivery services through a payroll or pension deduction. It is important to note that GHI HMO encourages the use of in-network doctors, and if out-of-network doctors are used, only Medicare coverage applies, with treatment subject to Medicare deductibles and coinsurance.

GHI HMO

With GHI HMO, individuals get access to a wide range of covered services from network doctors and hospitals for a small copay. The plan is available to active employees and non-Medicare-eligible retirees living in New York City and several New York State counties. GHI HMO also offers a Medicare Senior Supplement plan that covers the same services as the standard plan, plus additional benefits for Medicare-eligible retirees.

Under the GHI HMO plan, individuals choose a regular doctor who will manage and oversee their care. This includes administering referrals to network specialists and arranging hospital stays. The plan offers a comprehensive range of in-network services, including the choice of doctors in private practice or at physician group practices (PGPs).

The GHI HMO plan typically includes the following in-network costs:

• PCP office visit: $15 copay
• Specialist office visit: $15 copay
• Diagnostic lab: $0 copay
• Routine physical exam: $15 copay
• Outpatient mental health: $15 copay
• Urgent care: $15 copay
• Ambulatory surgery: $0 copay
• Emergency room: $35 copay (waived if admitted)

Individuals can also choose to add prescription drug coverage to their GHI HMO plan, which includes generic and brand drugs from network retail drug stores and home delivery services.

GHI International Medical Insurance

GHI, or General Health International, is a global health insurance provider with a worldwide network of over 10,000 first-class medical providers. GHI is committed to servicing individual and corporate customers by providing an extensive range of high-quality, fully-compliant insurance products and services.

GHI health plans do not require a referral from your primary care doctor to see a specialist. Customers can easily access treatment on direct billing at various providers via GHI's extensive network. GHI also offers swift claims processing, with the majority of claims settled directly with service providers. Customers are also offered access to a second medical opinion at no extra cost.

GHI plans include all the most important features as standard. Whatever your choice of GHI health plan, you are covered for inpatient and day-patient care, chronic conditions (including HIV/AIDS treatment), complications of pregnancy, evacuation and repatriation. GHI offers three insurance products: VITAL, EXCELLENT, and PRIME.

GHI Merger with HIP

Group Health Incorporated (GHI) and the Health Insurance Plan of Greater New York (HIP) merged in 2006 to form EmblemHealth, one of the United States' largest non-profit health plans. The merger was announced on September 29, 2005, by the boards of directors of both companies. The new company would be governed by a foundation composed of an equal number of directors from GHI and HIP.

GHI was established in 1937 to provide New York's working families with access to medical services through a network of participating providers. This model was a precursor to the preferred provider organization (PPO). Over the years, GHI expanded its presence in the upstate New York market and acquired various assets, including ABC Health Plans in 2005.

HIP, incorporated in 1944, was the first health insurance plan for public service workers in New York. Founded by David M. Heyman with the support of New York City Mayor Fiorello LaGuardia, HIP aimed to offer medical services to New Yorkers of "moderate means." In addition to its medical centres, HIP began offering services through a physician provider network in 1997. HIP also expanded through acquisitions, including Vytra Health Plans Long Island in 2001 and ConnectiCare Holding Company, Inc. in 2005.

The merger of GHI and HIP created the largest health insurer based in New York State. The combined company, EmblemHealth, serves more than four million members across the tri-state area. The merger aimed to provide expanded access to healthcare and cost savings for NYC taxpayers.

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