About Commercial HMO and PPO Managed Care
What is a Commercial managed health care plan?
- You have a regular doctor
- You can get regular check-ups
- There is no limit on the number of visits you or your children can have with your doctor
- You can reach your provider's office or health plan 24 hours a day, 7 days a week
- You can access clinics, laboratories, specialists, and hospitals
What is a the difference between a Commercial HMO and a Commercial PPO?
- In a Commercial HMO, the health plan works with a group of providers. Members choose or are assigned to a primary care provider. Specialists may require referals from the primary care provider.
- In a Commercial PPO, members may choose any health provider within or outside of the plan's listed providers (provider network).
Where can I compare Commercial health care plans in my area?
- Visit the New York State Department of Health Choosing a Health Plan website.
How do I enroll in a Commercial managed health care plan?
- Visit the New York State of Health Marketplace website to learn about available New York State managed health care plans. At this website you can compare health plans as you enroll in coverage. The Marketplace is open to all New York State residents.
Having problems with your health care plan?
| For problems concerning payment, reimbursement, coverage, benefits, rates, or premiums | Contact the Consumer Assistance Unit at the New York State Department of Financial Services website or call 1-800-342-3736 |
| For issues about the care you are receiving | Contact the New York State Department of Health website, or call 1-800-206-8125 |
| Do you want to file a complaint? | Use the online DFS Consumer Complaint DFS Portal | Have you been denied coverage? | Contact the New York State Department of Financial Services external appeals website, or call 1-800-400-8882 |
