Managed Care Facts

As of December 2013, there are 10 fully licensed managed care health plans, 8 PHSPs and 10 MLTC plans in New York. New York Health Plan Association (HPA) member plans provide health care to nearly seven million New Yorkers enrolled in fully-insured managed care plans. Additionally, the New York State Health Insurance Program (NYSHIP), the state’s own preferred provider organization (PPO), provides health benefits to more than one million government employees and their families. Overall, managed care health plan enrollment in New York accounts for more than 36% of the state’s total population, and more than 42% of the insured population.1

New York’s health plans provide coverage to virtually every segment of the population including:

  • 960,700 New Yorkers enrolled through NY State of Health—The Official Health Plan Marketplace;
  • 980,000 New Yorkers enrolled in HMO and point-of-service (POS) products. POS options allow people to see providers outside the plan’s network and generally appeal to consumers with greater health care needs;
  • 3.5 million Medicaid recipients enrolled in health plans through the New York State Medicaid managed care program;
  • 432,000 previously uninsured New Yorkers covered by plans participating in the Family Health Plus program;
  • 304,500 previously uninsured New York children covered by plans participating in the Child Health Plus program;
  • 1.1 million New Yorkers enrolled in Medicare managed care (Medicare Advantage);
  • 120,000 New Yorkers enrolled in mainaged long-term care plans; and
  • 112,600 previously uninsured New Yorkers covered through health plans participating in the state’s Healthy New York program.

HPA’s member health plans are a vital part of communities throughout the state and significant contributors to New York’s economy. Plans provide jobs to thousands of New Yorkers, invest in community-based organizations, pay taxes. They also have a commitment to their communities and to quality improvement.

Download an HPA Fact Sheet that outlines the positive impact plans have in New York: