EMPIRE PLAN CLAIMS DEADLINES FOR CALENDAR YEAR 2018

Empire Plan enrollees have until April 30, 2019 (120 days after the end of the calendar year) in which to submit medical expenses which were incurred during the 2018 plan year to:

United HealthCare Service Corp.

P.O. Box 1600

Kingston, N.Y. 12402-1600

www.empireplanproviders.com/claimform.htm

For the Empire Plan Basic Medical Program, the Home Care Advocacy Program (HCAP) and for non-network physical therapy or chiropractic services

Empire Blue Cross and Blue Shield

NYS Service Center

P.O. Box 1407 – Church Street Station

New York, NY 10008-1407

For Empire Plan and non-network Inpatient or Outpatient hospital services

 Beacon Health Options

P.O. Box 1850

Hicksville, NY 11802

For non-network mental health and substance abuse services 

CVS Caremark

P.O. Box 6590

Lee’s Summit, MO 64064-6590

For prescriptions filled at non-participating pharmacies or at participating pharmacies without using your New York Government Employee Benefit Card 

Enrollees can call the Empire Plan at 1-877-7NYSHIP (1-877-769-7447) with questions or to obtain claim forms. As a reminder, when using the Empire Plan’s toll-free telephone number, please pay extra attention to the choices offered by the automated system.

Network providers/pharmacies will submit claims directly to the appropriate insurance carrier on your behalf when provided with all necessary information.  If you have a non-network claim submission, make sure you complete the requested subscriber information on the claim form, include the original billing or receipt (if requested), and don’t forget to sign the claim form.