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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.
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 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 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 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.
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!
2 Customer Reviews of “GHI Health Insurance Company”
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Review by RAP, August 18, 2009
“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 a “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 sometime denied becuase 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 requiries 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?
Review by SHNewman, March 18, 2010
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 a 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.
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