Please keep in mind that, under the medical component of the Empire Plan, you are not guaranteed access to a participating provider in every specialty in every geographic area. Also, providers listed in the directory are not obligated to accept new patients. The Empire Plan does not require that a participating provider refer you to a participating specialist, laboratory, urgent care center or outpatient surgical locations. Ask for a participating provider. When you use a non-participating provider, covered benefits are payable under the Basic Medical portion of the Plan, but using a participating provider lowers your out-of-pocket expenses. Always ask your provider if he or she is a participating provider before you receive services.
For physical therapy and chiropractic services, managed care components of the Empire Plan, you are guaranteed access to a participating provider. Call 1-877-769-7447 if you need help locating a participating provider in those specialties.
You may search this directory two different ways. If you know the ZIP Code you want to search - select "Express (by Zip Code)." Enter a ZIP Code, desired mileage radius and select the type of provider you want to find and hit the search button. You will receive the results of your search, or suggestions as to how to expand your search, if the search is unsuccessful. Adding the provider's last name, or the first initial of the provider's last name, is an optional search.
If you are unsure about the type of provider you may need to visit for a particular condition, provider definitions are available for your assistance. To search for a physician definition visit "Find Physicians", enter your desired city, state and zip code and click "show related specialties" for details. To search for a facility definition visit "Find Laboratory or Other Facility", select "Search for Any Other Type of Facility", enter your desired city, state and zip code and you can view provider definition details.
For most health care, call your primary care physician first. You'll find primary care physicians listed in the directory under General Practice, Family Practice, Internal Medicine, Pediatrics and Gynecology/Obstetrics. Your primary care physician can help you find an appropriate specialist, if you need one. However, you do not need a referral to receive care from a medical specialist. If your doctor refers you to a specialist or sends samples to an independent laboratory, ask for an Empire Plan participating specialist or laboratory. Using a participating specialist or laboratory lowers your out-of-pocket costs.
If you need homecare services, such as skilled nursing, home infusion, durable medical equipment or supplies, including diabetic supplies or ostomy supplies, you must call HCAP, the Home Care Advocacy Program at 1-877-769-7447.
Take your New York Government Employee Benefit Card with you each time you go to your provider's office. Please remind your covered spouse/domestic partner and children to use their cards.
If you have questions about the Empire Plan's Participating Provider Program or Managed Physical Medicine Program, please call UnitedHealthcare at 1-877-769-7447.
When you choose a participating provider, you pay only your copay for covered services and the provider files the claim. Using participating providers can greatly reduce your out-of-pocket expenses and help contain premium costs.
If you have questions about The Empire Plan's Participating Provider Program or Managed Physical Medicine Program, please call the Empire Plan at 1-877-769-7447 and choose UnitedHealthcare.