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To get the most out of the Empire Plan (or any health insurance), it is important to familiarize yourself with all of its features and requirements. We can help you with this process.

What is The Empire Plan

The Empire Plan is a health insurance plan offered by the state of New York to state employees, their families, and other groups. As part of NYSHIP (the New York State Health Insurance Program) the goal of the Empire Plan is to provide high-quality, comprehensive health insurance coverage to eligible individuals at an affordable price. The plan provides coverage for a wide range of medical services, including hospitalization, outpatient care, prescription drugs, and preventive care. It is designed to help members access the health care they need when they need it, and to help them manage their health and wellness over the long term.

Who Created The Empire Plan 

The Empire Plan was originally created through a partnership between the state and the groups representing their employees. The stated goal of the plan is to provide the “best health insurance benefits at the lowest cost.” Under the supervision of the Department of Public Works, the stated goal of the Empire Plan is to provide the “best health insurance benefits at the lowest cost.”

What Services Are Covered By The Empire Plan 

The Empire Plan covers a variety of services, including:

  • Dental services
  • Vision services
  • Prescription drugs
  • Home health care
  • Hospice care
  • Physical therapy
  • Occupational therapy
  • Chiropractic care
  • Pediatric services
  • Medical equipment

What Companies Does The Empire Plan Rely on to Provide Coverage

The Empire Plan relies on various large companies such as Anthem and UnitedHealthcare to provide coverage. Hospitalization and related expenses coverage, one of the main features of the Empire Plan, is provided through Empire HealthChoice Assurance, part of the Anthem BlueCross. The coverage includes a combination of independent BlueCross and BlueShield plans, although surcharges may apply for certain outpatient services.

UnitedHealthcare Insurance Company of New York offers most of the medical and surgical benefits. Services under the Empire Plan are covered for seeing in-network or out-of-network providers. The Empire Plan also has a benefit management program to accredit hospitals and skilled nursing facilities and to cover MRI, CT, PET, and nuclear medicine testing procedures. UnitedHealthcare is also responsible for home care services, durable medical equipment, and select equipment.

The Empire Plan offers its different services through partnerships with different companies, but many of the services are still managed by UnitedHealthcare. Physical medicine programs for chiropractic care, physical therapy, and occupational therapy through UnitedHealthcare and OptumTM Physical Health.

The Empire Plan has a Transplant Program Center of Excellence through Empire BlueCross and Centers of Excellence for the Infertility and Cancer Programs through UnitedHealthcare.

Mental health and addiction programs are covered under the Empire Plan through Beacon Health Options These services may include treatments such as therapy, counseling, medication, and support groups.

Prescription drug coverage is provided through CVS Carmark, part of CVS Healthcare, a  large retail pharmacy. CVS Caremark also offers mail-order and specialty pharmacy services in addition to their brick-and-mortar retail stores where you can pick up a prescription.


To get the most out of the Empire Plan, it is important to familiarize yourself with its features and requirements. These include the Benefit Management Program, Home Care Improvement Program, Managed Physical Medicine Program, and Infertility Benefits. It is also important to be aware of potential changes to annual net deductions, maximum combined annual income, and payments. By understanding the features and requirements of the Empire Plan, you can make sure you receive the care you deserve at the lowest cost.