Switching Health Insurance Plans

Choosing the right health care coverage is one of the most important decisions you can make for you and your family. It’s essential for you to fully understand your options and choose a policy that is best for your current and future health care needs. The choices you make today can secure or compromise your family's medical and financial future tomorrow.

Whether you're selecting a health insurance plan at work, or purchasing one on your own, here are three important questions to ask before picking a plan:

  • What does the policy cover?
  • Can I have a list of participating physicians and facilities?
  • Is the plan in-network with Roswell Park and its providers?

What is Open Enrollment? (and what do I need to do?)

Open enrollment refers to a time period each year (usually several weeks in the fall) when you may enroll in health insurance or change your health insurance plan for any reason. The dates of this time period will depend on the type of insurance, such as whether the plan employer-based, a Medicare plan, or purchased from the NY State of Health Marketplace.

Open enrollment is the perfect time to evaluate your current health insurance plan, learn whether it covers services at Roswell Park and whether Roswell Park is an in-network provider. Then, you can make an informed decision about whether you wish to opt for another plan. If you miss this time period, you won’t be able to newly enroll or change your plan unless you have a qualifying life event such as loss of other coverage, becoming a dependent or gaining a dependent, moving to a new area and other situations.

Roswell Park wants you to receive the high quality of care you deserve

Learn more about options to consider when selecting a healthcare plan.

Understanding health insurance

Why you need access to cancer care at Roswell Park

Roswell Park is much more than a cancer hospital. We are a comprehensive cancer center designated by the National Cancer Institute and the only one in the state outside of New York City. We offer treatments at the forefront of cancer care and nationally recognized physicians with the knowledge and experience to use them. Learn more about why you need Roswell Park Comprehensive Cancer Center in your healthcare network.

If you’re diagnosed with cancer, you want to receive treatment from an NCI-designated cancer center that devotes 100% of its time to studying, diagnosing, treating and preventing cancer. If your plan doesn’t include this option, it might be time to switch.

Check your current plan

You will need the name of your healthcare insurance company and the name of your specific plan. Check the list below:

All Health Plans and Networks

Insurance Company Insurance Product Hospital Participation Status Physician Participation Status
Aetna Commercial/Self Funded Yes if accessed through Magnacare** Yes if accessed through Magnacare**
Aetna Dental Dental Network n/a Yes
Allegany/Cattaraugus County Cancer Services Program Other Yes Yes
American Indian Health Program (AIHP) NYSDOH Yes Yes
Amerigroup (Blue Cross Blue Shield of Western New York HealthNow) Child Health Plus Yes Yes
Medicaid Yes Yes
Azeros Health Plan (Nova Dentalcare) Dental Network n/a Yes
BDCT (Blue Distinction Centers) - Transplant Network Other Yes Yes
Carelon Behavioral Health (formerly Beacon Health) Other Yes Yes
Chautauqua County Cancer Services Program Other Yes Yes
Cigna* Commercial/Self Funded Yes if accessed through MVP** Yes if accessed through MVP**
Cigna LifeSource - Transplant Network Other Yes Yes
Contigo Health (formally Three Rivers Provider Network) Other Yes Yes
Coventry Other Yes Yes
Delta Dental Dental Network Yes Yes
Dentaquest Dental Network Yes Yes
Emblem Health/GHI Commercial/Self Funded Yes Yes
Medicare Yes Yes
EmpirePlan (UHC) Commercial/Self Funded Yes *Physicians covered by United, Hospital services covered by BCBS
Erie County Cancer Services Program Other Yes Yes
Fidelis EPP Yes Yes
HARP Yes Yes
Medicaid Yes Yes
Child Health Plus Yes Yes
Medicare Yes Yes
Exchange Yes Yes
First Health Other Yes Yes
Genesee, Orleans, Wyoming and Niagara Counties - Cancer Services Program Other Yes Yes
HealthPlex Dental Network n/a Yes
Highmark Western and Northeastern New York (formally Blue Cross Blue Shield of Western New York) Commercial/Self Funded Yes Yes
Medicare Yes Yes
EPP Yes Yes
Exchange Yes Yes
Child Health Plus Yes Yes
Medicaid Yes Yes
Humana ChoiceCare Commercial/Self Funded Yes Yes
Humana Military Tricare East Prime Yes Yes
Tricare East Select Yes Yes
Independent Health Commercial/Self Funded Yes Yes
Health Benefit Exchange Yes Yes
Medicare Yes Yes
Medicaid Yes Yes
Essential Plans Yes Yes
Child Health Plus Yes Yes
Exchange Yes Yes
Indian Health Services (IHS):
Including -
a)Tuscarora, Tonawanda Seneca
b) Seneca Nation Allegany/Salamanca, Seneca Nation Cattaraugus/Irving
c) St. Regis Mohawk		 DHHS Purchased/Referred Care Yes Yes
Interlink - Transplant Network Other No No
Liberty Dental Dental Network n/a Yes
LifeTrac - Transplant Network Other Yes Yes
Lifetime Benefit Solutions (EBS-RMSCO) Commercial/Self Funded Yes Yes
Magnacare Commercial/Self Funded Yes Yes
Medicare No No
Medicaid No No
Managed Care Advisors (MCA) - Sedgwick (World Trade Center) Other Yes Yes
Martin's Point Healthcare (US Family Health Plan) Other Yes Yes
MedCal Other Yes Yes
Medicaid (New York) Medicaid Yes Yes
Medicare Medicare Yes

Yes
Molina HealthCare
(formally YourCare Healthplan)

 

 EPP Yes Yes
Medicaid Yes Yes
Child Health Plus Yes Yes
Multi Plan (PHCS - Private HealthCare Systems Inc) Other Yes Yes
MVP (Preferred Care) Commercial/Self Funded Yes Yes
Medicare Yes Yes
Exchange Yes Yes
EPP Yes Yes
HARP Yes Yes
Medicaid Yes Yes
Optum Health URN CRS - Transplant Network Yes Yes
VA Community Care Network (VACCN) Yes Yes
UHC Dental Dental Network n/a Yes
United (UHC)* Commercial/Self Funded Yes if accessed through Multiplan or CRS** Yes
Medicare No No
Exchange No No
Medicaid No No
Univera HealthCare Commercial/Self Funded Yes Yes
Medicare Yes Yes
Exchange Yes Yes
EPP Yes Yes
Medicaid Yes Yes
Child Health Plus Yes Yes

*If you are accessing Roswell Park Comprehensive Cancer Center with one of these health plans, please be advised that you may be subject to higher out of pocket costs.

** Although Roswell Park Comprehensive Cancer Center is not directly participating with the health plan, please call us at 1-800-ROSWELL to determine if your plan allows for out of network benefits.

**Updated Health Plan Partnerships 7/18/23

FAQs

Here are some answers to some of the most common questions about open enrollment

Open enrollment is the period of time each year when you can enroll in a health insurance plan. Typically you cannot enroll in or change plans outside the open enrollment period unless you have a qualifying life event (e.g. loss of insurance, permanent move to a new area, loss of job, divorce/marriage, age off parent’s plan).
  • Medicare’s open enrollment period runs from October 15th through December 7th.
  • NY State of Health Marketplace’s open enrollment period runs from November 1st through January 31st.
  • Job-based plans’ open enrollment period is determined by your employer, but are typically in the fall.
  • Medicaid, the Essential Plan, and Child Health Plus allow you to enroll at any time.
Yes, Roswell Park accepts both traditional Medicare and New York State Medicaid.
  • If you are enrolling in a Medicare Managed Care Plan, please consider enrolling in a plan that is in-network with Roswell Park (BlueCross Blue Shield of WNY, Independent Health, MVP, and Univera Healthcare). Otherwise, if you choose a plan that is out-of-network, your plan may not cover your services at Roswell Park and/or you may have higher out-of-pocket costs.
  • If you are enrolling in a Medicaid Managed Care Plan, you should select a plan that is in-network with Roswell Park (BlueCross BlueShield of WNY, Fidelis, Independent Health, and Yourcare). Otherwise, if you choose a plan that is out-of-network, all services will require prior authorization and/or you may not be able to receive services at Roswell Park.
Please contact your insurance company to find out if your plan is participating with Roswell Park and its providers. You can also call us at 1-800-ROSWELL or email us at askroswell@roswellpark.org with questions.
When a provider is in-network it is contracted with the insurance plan to provide services to its members. An out-of-network provider is not contracted with the insurance plan. If you receive services from a provider that is in-network, your out-of-pocket costs will typically be less than if you receive services from an out-of-network provider. Services provided by out-of-network providers may not be covered under your plan.

If you have out-of-network benefits, you may be able to still receive services at Roswell Park. However, an out-of-network authorization may be required – this means we would need a prior approval by your insurance plan for you to have services at Roswell Park. Another important factor to consider when deciding to go to an out-of-network provider is the financial responsibility. Typically an insurance plan will pay less when you receive services out-of-network and will hold you responsible for a larger portion of the bill. For example, you may have 20% coinsurance for in-network services, but 40% coinsurance when you go out-of-network. In addition, you may be responsible for paying the difference between Roswell Park's charges and your insurance plan’s usual and customary rates.

There are many factors to consider and compare when picking an insurance plan, but two key components are coverage and cost. First, you want to make sure the providers (your primary care doctor, specialists, hospitals, etc.) that you use are in-network and participating with the plan you choose. Second, you should consider the total health care costs (monthly premium, deductible, copays and coinsurance, and out-of-pocket maximum). Generally, plans with higher premiums have better coverage and lower out-of-pocket expenses.

Is Roswell Park and its providers in-network with my plan? (You may need to provide our Tax ID number 161552370 and our NPI numbers: Roswell Park (Hospital) 1548315401 and Roswell Park (Physicians - RPCI CPP) 1720036593)

If yes:

  • What are my co-pays for specialist office visits, ambulatory surgery, chemotherapy, radiation, radiology, and inpatient admissions?
  • What is my maximum out-of-pocket cost (MOOP)?

If no:

  • Do I have out-of-network benefits?
  • Does my plan require out-of-network authorizations?
  • What are my out-of-network benefits (deductible, coinsurance, out-of-pocket maximum)?
  • Does my insurance plan access any special networks (such as Cancer Resource Services, MultiPlan, or MagnaCare) for which Roswell Park is an in-network provider?
  • Will I be balance billed for the difference between the usual and customary rates and Roswell Park’s charges?
If you have out-of-state insurance, you should check with your insurance plan to see if your plan has out-of-network benefits.
If you miss the open enrollment deadline, you will have to wait to change insurance plans until the open enrollment period next year. You are only allowed to change plans outside the open enrollment period if you have a qualifying life event such as getting married, having a baby or losing health coverage.

Questions?

Our financial counselors are ready to assist you with any of your open enrollment, health insurance and billing questions. You can call us at 716-845-4782.