Are you on the hunt for a complete Oxford Health Insurance Review or more specifically Oxford Health Plan Group Insurance Review then you are at right place.
Who are we & why did we write this?
212-484-9888.com is a Health Insurance Broker based in NYC. We are brokers to Health Insurance Carrier like Oxford, HealthFirst, Empire, Emblem &, etc
This guide is related to unsubsidized commercial insurance.
Please see below updates regarding COVID-19, formerly known as the novel coronavirus or COVID-19.
Your costs are covered for COVID-19 tests: UnitedHealthcare has waived all member cost-sharing, including copays, coinsurance, and deductibles. UHC will cover a provider visit for COVID-19 in the same way that we cover other provider visits based on your health benefits.
Where do I get the test? If your PCP or medical professional thinks you may have COVID 19, they will contact the CDC or local public health department for steps to follow on testing.
Diagnosis Coding Update: When submitting COVID 19 related claims, Providers will follow the appropriate CDC guidance on diagnosis coding for the date of service. CDC has provided coding guidance to providers.
Telehealth Care and Services: Effective immediately, UHC is expanding policies around telehealth services for Medicare Advantage, Medicaid, and commercial membership– waiving the CMS originating site restrictions for Medicaid so that care providers can bill for telehealth services performed while a patient is at home. We also received new Medicaid guidance from CMS this morning, and actively working to put codes and a process in place. Please bear with us as we work through this.
Access your health plan account for information on network health care providers, benefits coverage and more
Request early prescription refills – UHC members can also fill existing prescriptions early (one time, up to a 90-day refill) through the direct pharmacy or mail order. Members should call the pharmacy number on their ID card, or speak directly to a pharmacist in order to get an early refill.
Get emotional support: Call our emotional support line at any time at 866-342-6892. This 24/7 Optum HelpLine is staffed by professionally trained mental health experts. Free of charge and open to anyone.
Please visit the UHC COVID-19 page for more details. This page also has a link to Member FAQs.
For the complete information, click the image below
Oxford Small-Group ID change from now to April 2021
Oxford Group that are renewing in
Oxford Notification For New Or Renew Group
Effective 5/1/2020 upon renewal, Oxford NY (1-100) small groups and NJ (1-50) will receive enhancements.
These enhancements include a new Member website, an enhanced advocacy customer service model, virtual doctor visits, and other value-added features.
What this means for your employees:
1. New health plan ID cards. Your employees and their covered dependents will receive new health plan ID cards, which will show a new member ID number, new group ID number, and the new Member website address, myuhc.com.
Upon the new policy effective date, the old card(s) should be destroyed.
Members will need to present their new card the next time they visit the doctor or pharmacy after their new policy effective date.
2. New Member website. Members will have a new website, myuhc.com, that they should begin using upon your group’s new policy effective date. Once the member logs in, the new website will show the same
Oxford logo they are used to seeing on their plan materials. Information about how and when to register* for myuhc.com will be mailed to your employees.
Please contact Call 1-888-201-4216 if you experience any issue login to www.UHCeServices.com
Oxford CT Group Health
Please provide the group name, address, census and nature business to have a group quote.
To enroll the health plan, except for the enrollment forms need to be filled, please also provide the tax documents below
UC5A, new hire needs two weeks payroll and the owner need the K1/Schedule C.
Oxford NJ Group Health
Please provide the group name, address, census and nature business to have a group quote.
To enroll the health plan, except for the enrollment forms need to be filled, please also provide the tax documents below
WR30, new hire needs two weeks payroll and the owner need the K1/Schedule C.
2021 Oxford Group Health New Benefit
The Broker Connect article announces the continuation of the enhancements rollout with our Oxford business. Beginning with May 1, 2020 case effective and renewal dates, we will be extending the enhancements to our Oxford fully insured New York small group (1-100) and New Jersey small group (1-50) customers. As a result, Oxford members in these segments will be the next to have what’s designed to be a more robust and streamlined service experience for their medical benefits. The enhancements include:
Yes, that is likely the reason you have found our article on Google.
Well, Oxford Health is not to be related to the famous Oxford University in Oxford, England. Rather it is a subsidiary of United Health Care (UHC), or, publicly listed as United Health Group on the NYSE exchange.
Oxford Health Insurance 2021 insider guide. Is it right for you? Evaluate Doctor’s networks, Urgent Care Center, Hospitals, Payment links, CSR and many more.
We are brokers, to UHC, Empire BCBS, Healthfirst and many others.
Very often, we are being asked?
Is United Healthcare good insurance?
UHC-Is-World-Largest-Insurance-Carrier-?
Is the biggest health insurance company the best or worst?
I can surely tell you that UHC parent company, United Health Group is surely the largest health insurance carrier in America, if not the work.
According to our screen capture, with net revenue of close to $190 billion in 2016, it is more in 2019, UHC revenue is more than Iraq GDP.
However, the biggest company may not equal to the best.
The bigger company comes with less flexibility.
Check out Youtube complaint of HIV medication decline
On the above, it is a pissed consumer who has his HIV Medication declined by UHC/Oxford, most likely the Optum unit.
Many consumers didn’t realize, the health insurance company is there to work for their executive and a lesser extent, their shareholders.
It is never in the for-profit company’s best interest to take good care of its consumers.
In this person case, I am pretty sure that by law, UHC or Oxford has to cover a version of the medication that will keep him alive.
Conveniences and nightmare of Mail Order Prescription
While, the specific medication that he is looking to get, maybe a lot of conveniences (he can only take the medication once a week versus daily), but it is not in the interest of the insurance carrier. In this case, Oxford or UHC’s Optum unit.
Hence, there is a lot of problem with formulary or what plans is best.
In my opinion, there is no such best plan that fits everybody.
Click to find out if you are eligible for zero-premium medicare.
Click to learn more about zero-premium-medicare-scam?
Who else is not suitable for Oxford Health or UHC.
If you like to visit your neighborhood pharmacy for the regular maintenance medication, like your diabetic supplies or your Lipitor, you might not like Oxford, UHC.
Optum, the health information technology, and services firm of the UnitedHealth Group will make it useful to get their maintenance medication by mail orders.
I am not going to repeat the many negative feedback provided by the public.
The most useful thing from reading this article is, in the event where your life maintaining or saving medication did not arrive in time, you should always be able to call Optum, Oxford or UHC, to have them overwrite and provide you with the access to get your medication at a local pharmacy.
Insurance company profits can never triumph over a person’s livelihood.
Oxford can offer 3 plans for down to 3 enrolled.
So we can mix & match the PPO, HMO & EPO plans, in fact, we can offer 3 plans for a small group of 3 employees.
Often time, people may find that Oxford/UHC plans are overwhelming and confusing.
I think the last time we counted, there were about 47 plans for New York alone that are being offered by it’s Northeast subsidiary, which is Oxford.
So Oxford Health, Optum are both subsidiaries of UHC.
In fact, there is so many smaller company that is operating in different names and capacities within the United Health Group. Check out the latest filing fro the SEC.
Oxford Health Plans was founded in 1984, Oxford Health Plans, Inc. provides health plans to employers and individuals primarily in New York, New Jersey, and Connecticut, through its direct sales force, independent insurance agents and brokers.
Oxford’s commercial insured products and services include traditional health maintenance organizations, preferred and exclusive provider organizations, point-of-service plans and consumer-directed health plans.
The Company also offers Medicare plans and third-party administration of employer-funded benefits plans. More information about Oxford Health Plans, Inc. is available at www.oxfordhealth.com.
If you did click on the above link, you will be overwhelmed by the total of 40 plus plans Oxford Health is offering, just on the 2nd quarter alone in 2019.
The 47 plans are 10 folds that some other carriers are offering.
However, it also gives a lot of flexibility or the opportunity for people to either pick the best services available or to get the cheapest plan available.
If you click to view all the plans offered at the 2nd Quarter in 2019, you will actually be surprised to find out that Oxford Health insurance is even cheaper than OSCAR.
So, in short, don’t stress yourself out, as the premium you pay with or without a broker is the same, feel free to call us for help.
Oxford Acupuncture
Acupuncture is not a covered benefit.
Physical Therapy is 60 visits as indicated on all of our small group plan Summary Benefit Coverage.
Oxford becomes better or worst by merging with UHC
Oxford Health used to service only Connecticut, New Jersey, and New York.
After the merging process has completed, Oxford Health members now have access to the National Network.
The UnitedHealthcare Choice Plus Network is available to most Oxford Health members on an in-network basis.
For those groups enrolled in products with an out-of-network benefit, the national network benefit enhancement was automatic.
So the merger or acquisition by UHC allows Oxford member access to the nationwide choice plus network.
Eligible Oxford Health members can visit their doctor close to home or work and yet feel free to walk into the office of a UnitedHealthcare Choice Plus doctor while they are away with the comfort of knowing they are seeing an in-network doctor.
Choice Plus is now the network for all Oxford USASM products, making this an even more appealing plan to multisite groups headquartered in the Oxford service area.
However, the devil is in the details
Given the complexity of the Megastructure and the close to 50 plans that are offered by Oxford Health. (and with integration to UHC Choice plus networks)
We cannot take responsibility for user reading the information from here and make your own health insurance decision.
Even the health insurance carriers like UHC, BCBS always charge their end-users the same premium regardless of having a broker like us, so by not using a broker, we cannot be held responsible for your own decision.
The MyUHC.com access available for most of the United Health Care enrolled member are not available for members in the tri-state area, (that is, New York, New Jersey & Connecticut)
For members in the tri-state area, the online portal for Oxford Health is OXHP.com
Merging with UHC gives Oxford financial stability.
Yes, it is, by choosing the wrong HMO, EPO vs PPO combination, you will end up having an insurance plan that doesn’t cover you out of the network, like when your New York plan cannot cover you while you are in New Jersey and vice versal.
Let’s begin with Oxford’s newest network – The Metro Network. This network was introduced to small businesses in 2016.
Since it is relatively new, it has the smallest participation of doctors and hospitals. Metro is the lowest-priced Oxford plan of all three network options available in the New York service area.
• The Oxford Metro Network provides access to retail pharmacies including major chains, mass merchants and supermarkets like Duane Reade™, Walgreens®, and Walmart.® Prescriptions cannot be filled at CVS® or many non-chain pharmacies.
The most current list of eligible pharmacies can be found on oxfordhealth.com.
• Employees and their families can get care from over 44,572 physicians and 85 hospitals in New York.
• They also have access to more than 24,872 physicians and 67 hospitals in New Jersey.
The Metro does not offer National coverage whereas, Liberty and Freedom are accepted Nationwide. Metro plans also require doctor referrals from the Primary Care Physician (PCP).
Based on a figures provided by Oxford on April/2017
Silver
Platinum
Total
NY Metro
Nassau
Suffolk
Freedom
$ 799.30
$ 1,113.47
57800+
34200+
8700+
5400+
Liberty
$ 677.95
No Plan
51000+
30400+
7900+
4800+
Metro
$ 587.57
$ 849.24
29000+
17800+
3500+
2000+
HF
$ 616.82
$ 842.93
Oxford Metro Network Review (from UHC)
2021 Group Health Insurance Hospital Networks
Healthy New York is Metro Now, VERY IMPORTANT.
If 2021 is about saving money with your existing health insurance plan, we have an idea for you.
The biggest plus, It has NYP (Columbia/Cornell) networks of doctor & Sloan Kettering.
The plan is extremely not suitable for people living in Nassau county as Northwell is missing. (NYU to a smaller extend).
Hugh saving idea in 2021 (Offering Oxford Metro alongside Healthfirst), 5+
How about combining both Oxford Metro with Healthfirst to save money & has a complete overlap for each other? (Give us a call at 212-484-9888).
The Oxford Metro Network is our latest network option available for New York employers. This network was introduced to small businesses in 2016.
Since it is relatively new, it has the smallest participation of doctors and hospitals.
With some of the most competitive rates in the Oxford New York service area, the Oxford Metro Network may be just what you’re looking for to help balance employer costs and employee satisfaction.
Metro health plans are less expensive than other Oxford health plans but these plans require doctor referrals from the Primary Care Physician (PCP).
Unlike the Freedom and Liberty Networks, The Metro does not offer National coverage
With our 30-year track record for serving businesses like yours with our Oxford plans, we help deliver stability and are committed to the New York market.
Access to nearby pharmacies, doctors, and hospitals:
• The Oxford Metro Network provides access to retail pharmacies including major chains, mass merchants and supermarkets, Duane Reade, Walgreens, and Walmart are just some of the pharmacies where Oxford Metro Network members can fill prescriptions.
Prescriptions can no longer be filled at CVS, Target or many non-chain pharmacies.
The next step up from the Metro Network is the Liberty Network. It is estimated that Liberty plans have the second largest network of health care providers compared to the Freedom Network. Liberty HMO plans do not have employee participation requirements so these plans are a good fit for a business with only a few employees. A small business with only 2 employees could qualify for the HMO plan provided there is at least 1 employee on payroll.
The Liberty PPO and EPO plans require a 60% minimum employee participation to enroll in these plans. EPO and PPO plans have national coverage through the Unitedhealthcare Choice Plus network.
The Oxford Liberty Network is our mid-size network option available in our New York service area.
With a variety of plan options designed to fit your budget, the Oxford Liberty Network may be just what you’re looking for to help balance employer costs and employee satisfaction.
Liberty HMO plans do not have employee participation requirements so these plans are a good fit for a business with only a few employees.
A small business with only 2 employees could qualify for the HMO plan provided there is at least 1 employee on the payroll.
With our 30-year track record for serving businesses like yours, Oxford continues to deliver stability and is committed to the New York market.
Access to nearby doctors and hospitals:
Employees and their families can get care from 55,857 physicians and 98 hospitals in New York. When you add in the 28,709 New Jersey providers with the 19,671 Connecticut providers, our Liberty Network provides access to over 104,000 providers in the tri-state area.
• They also have access to more than 978,000 physicians and 6,100 hospitals nationwide through the UnitedHealthcare Choice Plus Network.
• PCP referral required for all in-network specialist visits (except OB/GYN)
With that being said, only the proper configuration, hence, you need a broker like us.
The Freedom Plan has the largest network of participation of doctors and hospitals in the eastern region. It also has National coverage through the Unitedhealthcare Choice Plus network.
Freedom plans have the best health care coverage options but they are also the most expensive health plans Oxford has to offer. This network is good for a small business that wants to offer the most comprehensive coverage to its employees and is willing to pay more for highest level of coverage.
The Oxford Freedom Network is our largest network of participation of doctors and hospitals in the eastern region.
Oxford understands that consumers want choice, flexibility, and access to quality healthcare coverage.
That’s why Oxford introduced the first point-of-service plans to the tri-state area in 1988. Oxford’s Freedom Plan gives members the freedom to choose how they want to receive care, in- or out-of-network.
Plus, members have access to one of the area’s quality network, our Freedom Network, with more than 60,000 providers, available in New York, New Jersey, and Connecticut.
With a variety of plan options designed to fit your budget, the Oxford Freedom Network may be just what you’re looking for to balance employer costs and employee satisfaction.
It also has National coverage through the UnitedHealthcare Choice Plus network.
Freedom plans have the best health care coverage options but they are also the most expensive health plans Oxford has to offer.
This network is good for a small business that wants to offer the most comprehensive coverage to its employees and is willing to pay more for the highest level of coverage.
With our 30-year track record for serving businesses like yours, Oxford continues to deliver stability and is committed to the New York market.
Access to nearby doctors and hospitals or nationwide:
Employees and their families can get care from 60,744 physicians and 98 hospitals in New York.
When you add in the 30,128 New Jersey providers with the 19,933 Connecticut providers, our Freedom Network provides access to over 110,000 providers in the tri-state area.
• They also have access to more than 978,000 physicians and 6,100 hospitals nationwide through the UnitedHealthcare Choice Plus Network.
• PCP referral required for all in-network specialist visits (except OB/GYN)
We have a mostly smaller group on our book, as for the larger group, we have placed them with PEO.
As for smaller company groups, Oxford Health is the most flexible and powerful carrier out there.
Our reviews/comments for all 3 networks
You got what you paid for, but the good news is, you have the flexibility of mixing and matching up to 3 or 4 plans for a small group of 3 or 4 employees or business partners.
Very Stable Doctor Networks.
Despite a slew of negative reviews for their Metro Networks, the Oxford Health doctor network almost never changed since the inception, with the exception of introducing the Metro Network a few years ago.
In summary, Oxford Health Pros & Cons
PROS
• Oxford makes our list of one of our top health plan providers in New York because it is one of the most widely accepted health coverage in the tri-state area. The company offers over 100 health plans within its 3 networks; The Freedom Network, Liberty Network, and the new Metro Network.
• All plans provide coverage to a vast network of doctors and hospitals in the New York region. Downstate coverage areas include The 5 boroughs – Manhattan, Brooklyn, Bronx, Queens, Staten Island, and Long Island, Nassau and Suffolk counties.
• Upstate coverage includes Westchester, Dutchess, Orange and Sullivan Counties. The Freedom and Liberty networks provide national coverage through the UnitedHealthcare Choice Plus network.
• If you are an immigrant, the network doctors are immigrant-friendly with many speaking a second language.
• You can turn to Oxford On-Call for your health concerns. It is a 24/7 health care guidance service provided by a registered nurse. (Click here for more details)
In short, if you are looking for a health plan with one of the best networks of coverage, Oxford is tough to beat.
CONS
• Oxford is way more COMPLICATED. (Please click to find out for yourself)
Because Oxford Plan is so complicated, it is almost always done with the help of a Broker, that is why they have always been one of our favorites. Empire BCBS is very complicated as well, but we don’t like to deal with them, that is for the sake of our client. We will leave it on another topic.
There are no good or bad plans or companies. Remember, it is always what is best for you!
Oxford Health Plans is one of the most premier providers of health insurance in the New York Tri-State area.
If your small business is willing to pay more to get the best coverage available, Oxford should be on your list of health insurance companies to compare.
Bonus For You
Oxford Health is featuring a Wellness Week with classes designed to help you keep your fitness goals on track.
You don’t need to be an Oxford Health member to participate.
Sign up today for a $5 class during our spring Wellness Week in April 2019.1 Wellness Week starts Monday, April 8, and goes through Sunday, April 14, 2019.
Call OBM Client Services toll-free at 1-888-200-1154, 8 a.m. – 5 p.m. ET, Monday – Friday, and follow the prompts. They can help with questions on eligibility, benefits, billing, and other administrative services.
Employees can also call a separate toll-free Customer Service phone number listed on their OBM ID cards or 1-800-521-9845.
Find Dental Providers
Below is a step by step employees can use in order to see the most up to date listing, without having to log-in:
Elite Plan: Groups enrolling in Contributory plans must have at least 75% of the active eligible employees enrolled, excluding those waived with spousal coverage (not to fall below 50% of all eligible employees).
Voluntary Plan: Groups enrolling in Voluntary plans must have at least 2 people enrolling to be eligible for coverage.
*For orthodontia, an employer group must have a minimum of 10 enrolling employees. Orthodontia benefits are for dependent children only up to the age of 18.
Oxford/UHC OBM Enrollment Request
Fill up the Employer/Employee Form (see above)
Lastest Tax Document (NYS 45)
Copy of the Binder Check
Please mail the check to the following address:
Oxford Benefit Management P.O. Box 780867 Philadelphia, PA 19178-0867