Page 17 - Work Force December 2023

Updates for 2024 for Empire Plan enrollees
Recently, the New York State Department of Civil Service, the administrator of the New York State Health Insurance Program (NYSHIP), sent out the October 2023 edition
of the Empire Plan Report, which summarizes Empire Plan benefit changes effective Jan. 1, 2024, and includes important reminders of preventive care covered by the Empire Plan.
Infusion Therapy Site of Care Program expanded
The Empire Plan’s new Site of Care Program will be expanded effective Jan. 1, 2024, to include
all drug infusion therapies except those used to treat cancer and hemophilia. Infusions that can be safely administered outside of a hospital setting will be transitioned to a freestanding infusion suite, your doctor’s office, or your home.
Patients who are currently receiving infusion therapy will receive a letter from the program to help transition them to an alternate setting, if medically appropriate. If home infusion is not an option for you or if there are no freestanding infusion centers or doctor’s offices within 30 miles or 30 minutes of your home, you can choose to continue receiving infusions in the outpatient hospital setting.
Questions regarding the infusion Site of Care Program should be directed to the Empire Plan at 1-877- 769-7447 and selecting the Hospital Program.
Empire Blue Cross becoming Anthem Blue Cross
Empire Blue Cross, the administrator of the Empire Plan Hospital Program, will be changing its name to Anthem Blue Cross as
of Jan. 1, 2024. This transition will not impact your coverage and you will still have access to the Plan’s network of hospitals, skilled nursing facilities and hospices. For questions regarding your benefits, call The Empire Plan and select the Hospital Program.
Here is more important
information regarding preventive vaccines and screenings that are included in the October 2023 Empire Plan Report:
Respiratory Syncytial Virus (RSV)
• For adults ages 60 and
older, the RSV vaccine is covered at no cost to you when provided by an Empire Plan participating medical provider or at an Empire Plan vaccination network pharmacy.
• For infants and children ages 0-24 months, RSV monoclonal antibodies are covered at no cost to you when provided by an Empire Plan participating medical provider.
• Effective Sept. 22, 2023, the RSV vaccine is covered in full for for patients between 32 and 36 weeks of pregnancy when administered by an Empire Plan participating medical provider.
COVID-19
The Centers for Disease Control (CDC) recommends COVID-19 primary series vaccines for everyone ages six months and older, and COVID-19 boosters for eligible individuals ages five years or
older. COVID-19 vaccines, including recommended updated boosters, provided by an Empire Plan participating medical provider or at an Empire Plan vaccination network pharmacy will be covered at no cost to you.
Influenza (Flu)
Flu vaccines are covered at no cost to you when provided by an Empire Plan participating medical provider or at an Empire Plan vaccination network pharmacy.
Preventive mammography screening
Recently, the U.S. Preventive Services Task Force lowered the
age in the federal guidelines for preventive screening mammography from age 50 to age 40. The Empire
Plan already covers screening mammography, as well as a 3D screening mammography every one to two years (depending on your doctor’s recommendation).
Note: There are no gender-based limitations applied to preventive care services under
The Empire Plan. Preventive care
services, like annual mammography
screening, are covered
at no cost to you when received from an Empire Plan participating provider.
The October 2023 Empire Plan Report stresses the importance of having a primary care physician. As a reminder, the Empire Plan is a unique health insurance plan that provides coverage whether you receive care from Empire Plan
network providers or from non- network providers.
Receiving services from Empire Plan network providers can save you time and money as your
out-of-pocket responsibility is usually limited to the
copayment for covered services by network
providers and network providers will handle many of the administrative
tasks for you, such as the submission
of claims to United Healthcare.
To find Empire Plan participating providers online, go to NYSHIP online at https://www.cs.ny. gov/employee-benefits. From the home page, select Find a Provider and scroll to the link to The Empire Plan Medical/Surgical Directory.
Retiring soon? Join the
Retirees!
• Money-saving member benefits
• Representation
to protect your pension and retirement benefits
• Access to insurance plans at CSEA’s low group rates
• Discounted dental and vision care programs
• Personal legal services referral network
• CSEA Retiree News
To learn more and join,
visit cseany.org/retirees or call 800-342-4146
Spouses, domestic partners and retired CSEA staff are eligible to join a CSEA Retiree Local, too!
December 2023
The Work Force 17