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GHI Health Insurance Company

If you are a New Yorker looking for an insurance company that has stood the test of time, GHI Health Insurance Company may right be for you. GHI Health Insurance Company started in 1937 with the goal of providing affordable, quality health insurance coverage to residents of New York.

The company’s two main goals are promptness and quality. They don’t want their members to have to wait for services or reimbursements, and they want all service to be quality service.

Here is some more information about GHI Health Insurance Company, so you can decide if this company meets your needs. Read through this GHI Health Insurance review, peruse the ratings and reviews of GHI left by members at the bottom of the page, and then use the free health insurance quote tool to find and compare quotes from the best health insurance providers in your state.

History of GHI

Since its inception in 1937, GHI has had many names, but by 1971 the name Group Health Incorporated was decided on as the final name for this growing company. GHI exclusively provides coverage for those in New York State and has become the largest non-profit health insurance provider in the state. GHI provides insurance for more than 2 million residents.

GHI has always tried to be on the cutting edge of the health insurance industry. They were the first company in NY to offer preventive care coverage, to over psychiatric care, to cover a second opinion before surgery is performed, and the first to offer paid-in-full benefits. In addition to this, GHI was the first company in NY to be chosen by the Social Security Administration to be a Medicare Part B carrier.

In 1951 GHI was the first insurance company in the nation to offer a comprehensive dental plan through their insurance program, thus becoming a prototype for the insurance industry. They continue today by seeing more than 3,000 members at their state of the art GHI Family Dental Practice facilities. They now offer medical, dental, vision, and mental health coverage under a variety of plans.

GHI Business Health Plans

GHI offers several health care plans for small businesses with up to 50 employees and large businesses with 51 or more employees. The GHI Alliance 365 Day Hospital-Only Plan is offered to small and large businesses. Coverage is given for inpatient and outpatient hospital stays, coverage is available at most NY hospitals, and across NY State. This plan has no deductible, no coinsurance, and enrollment is open so new employees don’t have a waiting period.

Another plan for businesses is the PPO Plan. This plan has a $0 co-pay for kids for office visits and any service performed at an office visit. There are no referrals needed with this plan and coverage is available throughout the state. For more coverage the Preferred Provider Organization HSA plan offers complete hospital, prescription drug, and medical coverage. It comes with a high deductible and is eligible for a Health Savings Accounts. There are no referrals, preventive care is covered and after you deductible is met, there are no co-pays.

The PPO Share Plan for businesses also has a $0 co-pay for kids. It offers complete prescription drug coverage, medical, and hospital coverage. This plan has co-pays, deductibles, and coinsurance. Coverage is available across NY State. There are also 4 HMO Plans to choose from each with its own features. All HMO plans have complete prescription, medical, and hospital coverage. There is a $25/$40 plan, a $30/$50 plan, and a $25 plan. The first cost is the co-pay for PCP visits. The second cost is the co-pay for specialists.

GHI Individual Health Plans

GHI plans for families and individuals have the same core values of quality and promptness. The GHI Alliance 365 Day Hospital-Only plan covers inpatient and outpatient hospital coverage. In-network coverage in most NY hospitals and coverage for out-of-network hospital services is available. There is no deductible and no coinsurance.

The GHI Alliance Value Plan covers basic hospital, medical, and prescription drug coverage. There are over 98,000 in-network providers available. No referrals are needed and coverage is available throughout the state. The Direct Pay HMO offers inpatient hospital services after a $500 co pay. Outpatient services are coverage after the same co pay amount. Well child visits and check ups are paid in full and a small co-pay applies to all other doctor visits. Prescriptions are paid for all in-network pharmacies.

GHI Dental Plans

GHI also offers dental plans for individuals and families. Their lowest priced plan called GHI Dental Access. This plan offers 100% paid in full service for preventive care, diagnostic services, exams, and x-rays. This includes two exams per year for adults and children, yearly bitewing x-rays, complete x-rays every three years, fluoride treatments yearly for children, space maintainers, and sealants. For additional services such as fillings, single crowns, root canals, and dentures services are significantly discounted.

Compare GHI Health Insurance Quotes

If you are considering GHI, it is a good idea to compare their plans to other companies. You can use the comparison tool on this page to get rates and quotes from top companies and see how they compare to GHI. Comparing different companies will give you a good idea of what coverage you can get and at what cost. Enter your zip code above and get started comparing health insurance companies right away!

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11 reviews

  • “The company’s two main goals are promptness and quality. They don’t want their members to have to wait for services or reimbursements, and they want all service to be quality service.”

    I almost fell over laughing reading this! They omitted that by their definition, neither prompt payment nor rational explanation for denials is a “service”. They don’t know what the term usual and customary means, instead calling it an “allowable fee”, as if beneficiaries care about semantics, and don’t bother even trying explaining the difference until it is too late for the beneficiaries to do something about it. That’s called entrapment.

    They sometimes denied because the service is not covered in the “group contract”, but won’t provide a copy of the “group contract”. Instead, they refer to a “Certificate of Insurance” whose opening statement implies that when there is a conflict between the certificate and the group contract, the group contract governs.

    Providers are sometimes non-existent; GHI apparently expects providers to tell them when they stop accepting their patients. Some may even be dead, but GHI requires them to get out of the grave and tell them they are no longer accepting patients, so they still list them as participating.

    I’ve wasted many days calling up everyone on their provider list local to me and came up empty, but to them, that’s “promptness and quality”. I wouldn’t even give them a single star. Does the right hand know what the left hand is doing there?

  • SHNewman /
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    In reading RAP’s review above, I can only agree at every point. Almost all providers on GHI’s list no longer or never accepted GHI insurance. Their list is an out-and-out deception.

    In my case, I was referred from a network provider to a network hospital for emergency care. The hospital assigned me a surgeon that wasn’t covered — who knew through the morphine? So, GHI argues that by selecting the basic coverage (don’t worry, the standard plan is almost as bad), I elected to NOT be covered if a network hospital assigned me an out-of-network surgeon.

  • Linda Jackson /
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    I started a GHI application. I saved the data and finished the application later. I have received over 400 emails from this company regarding this one application, wanting me to finish it. (Which I did!) They have a problem with their emails.

    DO NOT LOG ONTO THIS COMPANIES SITE!!! I can not get rid of their transmissions. (I sent them many emails to do this with no luck.)I may have to have my computer erased and restarted – and this is a big expense!

  • nick hewitt /
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    GHI IS A HORRIBLE COMPANY. bunch of scam artist making money off of peoples misfortunes, and it’s a shame they do.

    I WILL BE ENDING MY PREMIUM WITH THEM THIS MONTH. it is outrageous the price and I’m a MARINE. WTF DOES THAT MEAN TO THE GOVERNMENT. NOTHING I GUESS. JUST KEEP RAISING THE PRICE TO KEEP THE PEOPLE THAT KEEP YOU ALL FROM DYINGS PREMIUM. ALMOST MAKES SINCE.

    NO WONDER WHY THIS COUNTRY IS BEING FLUSHED DOWN THE DRAIN. THE WORLD IS ENDING>!

  • imelda fagin /
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    I didn’t give GHI an Overall bad rating because all of my doctors and hospitals accept it without a problem. I get my medicines and up to this week, I would have not had any complaints.

    This week, when I called to ask them a question unrelated to by immediate coverage, I discovered that they had ‘accidently’ terminated me from my COBRA coverage, which they provide. In switching banks that they used to accept electronic transfers, they said they had ‘dropped’ a number of customers.

    Did they make any efforts to notify these customers of THEIR mistake? No, But the next day I did receive a notification of termination due to failure to pay. I had not failed to pay, they had failed to accept my payment. It is all being slowly worked out. But in the meantime, I had to cancel an important medical test and a doctor’s appointment.

    By the way, the actual customer service reps were quite nice. So it’s coming from higher up.

    • 11111
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    Horrible. Worst customer service experience I’ve ever had in my life…the people, for the most part, are lovely, but powerless to actually do anything.

    My coverage was terminated (by a mistake on their part) and even while they acknowledge that mistake, it’s taking endless hours on the phone, every day, to try to get it sorted because here’s the big note: THE CUSTOMER SERVICE DEPARTMENT is DELIBERATELY separated from the membership department, and they swear there is no way for them to get in touch with membership (that from what I can tell actually processes the issues of relevance to patients) except for email. Seriously?

    There’s no reason for this that I can see except to try to “protect” the membership department from their clients who actually need help from them. The worst of corporate philosophy shaped the organizational structure of this company. I’m disgusted.

    • 11111
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    Terrible experience.

    Their “Comprehensive” benefits plan does not cover basic care, which they conveniently conceal. I feel incredibly deceived, and nobody at Emblem/GHI seems willing to help me.

  • crystalny11 /
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    Hello there,

    Whoever needs health insurance please STAY AWAY FROM GHI.

    YOU WILL GET UNEXPECTED BILLS MONTHS AFTER THE SERVICE. This is absolutely outrageous.
    Now I was wondering the bill they sent me is legal. Do they have the right to bill people in this way? Absolutely abusive!
    My blood pressure shot up for the nonsense they did. If my heart wasn’t strong enough, I would probably have died.

    If the unexpected bill I get is legal, then GHI truly has a very misleading, confusing, and TO BE HONEST, CONCEALING billing system.

    WE NEED A CLASS ACTION!!!

    This is billing abuse

    • 11111
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    Horrible deceiving lying company Along with doctors who lie about being a provider then you get stuck with an enormous bill and Ghi does nothing to protect their members!!!

  • Franklin Moore /
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    This is not insurance. It is fraud. The company makes you think you have insurance until you need it. I have spent whole days trying to find an internal medicine provider who will accept their insurance. No one will. Either they completely refuse to take it, or say they will not take new patients with GHI.

    Many of them apologize but say that GHI treats them worse than does any insurance company. They all say that you can pay us and then seek reimbursement on your own. I was ill and needed to see a doctor. I agreed to pay on my own as I have a deductible anyway. I paid $110 for an office visit. GHI gave me $12 credit towards my $200 deductible, saying that was the allowable charge.

    This is not insurance. They need to be out of business!

  • Fabian Feliciano /
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    GHI is not insurance! It’s a joke. Don’t really know why it’s offered as medical coverage. They pay for absolutely nothing. God forbid you get lab tests done.

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