New York Health Insurance Information - Family or Individual
(HMO, PPO, POS or Major Medical Coverage)
Individual or family health insurance can provide the important protection
needed in the event of illness and for regular preventive care. Using the
strength and experience of our health insurance markets, Edouard
Insurance Agency can offer affordable HMO, PPO, POS, and Major Medical
Health Insurance policy coverages throughout New York, including New
York City.
Health insurance plans that allow you the most choices in doctors and
hospitals also tend to cost more than plans that limit choices. Individual and
family health insurance plans that help to manage the care you receive,
such as PPO and POS plans, usually cost you less, but you must give up
some freedom of choice.
Learn more about HMO, PPO, and POS managed health care insurance
policies we offer throughout New York by clicking on a link below or click
on the link for information on Major Medical health insurance.
Click on the link below to fill out a secure quote request form for a New
York health insurance policy that provides excellent health insurance
coverage and services at an affordable cost. Or you can speak with one
of our New York Health Insurance specialists at (845) 426-0868 to
discuss the features.
We are your local Rockland County, NY insurance agency, offering affordable New
York health insurance policy premiums to residents located in the following cities and
counties: Spring Valley, Congers, Nyack, Palisades, Sparkill, Tappan, Orangeburg,
Pearl River, West Nyack, New City, Blauvelt, Nauraushaun, Nanuet, Chestnut Ridge,
Montebello, Suffern, Monsey, Piermont, Rockland Lake, Wesley Hills, New
Hempstead, Pomona, Sloatsburg, Tuxedo Park, Southfields, Ramapo, Hilburn,
Greenwood Lake, Warwick, Bellvale, Wickham Village, Monroe, Harriman, Chester,
Goshen, New Hampton, Highland Mills, Willow Grove, Mt. Ivy, Thiells, Tomkins Cove,
Ladentown, Haverstraw, Stony Point, Tomkins Cove, West Haverstraw, Bear Mountain,
Jones Point, West Point, Cornwall-on-Hudson, Mountainville, Salisbury Mills,
Craigsville, Washingtonville, Newburgh, New York City, Middletown, Poughkeepsie,
Port Chester, Harrison, Mamaroneck, Larchmont, New Rochelle, Yonkers, White
Plains, Rye Brook, Scarsdale, Rye, Ardsley, Eastchester, Pelham, Greenville,
Hartsdale, Bronxville, Tuckahoe, Mt. Vernon, Bronx, Irvington, Glenville, Valhalla,
Elmsford, Dobbs Ferry, Hastings-on-Hudson, Greenburgh, Tarrytown, Sleepy Hollow,
Hawthorne, Scarborough, Thornwood, Briarcliff Manor, Ossining, Harmon, Montrose,
Crugers, Buchanan, Peekskill, Millwood, Pleasantville, Armonk, Chappaqua, North
Castle, Mt. Kisco, Bedford, Pound Ridge, Bedford Hills, Cross River, South Salem,
Yorktown Heights, Goldens Bridge, Amawalk, Yorktown, Katonah, Salem Center,
Somers, North Salem, Croton Falls, Jefferson Valley, Shrub Oak, Putnam County,
Orange County, Dutchess County, Ulster County, Sullivan County, and Westchester
County, NY.
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HMO Health Insurance Policy Features - New York

* Preventive care emphasis
* Primary care physician (PCP) coordinates your total care
* Must get a referral from your PCP to visit a specialist
* Fixed monthly fee
HMO Health Insurance Policy Overview - New York

Subscribers to an HMO receive medical services from participating physicians,
clinics and hospitals. You choose a primary care physician (PCP) from a list of
participating doctors from where you live in New York. That doctor is used for
typical circumstances such as annual exams and usual health issues. If you
need to see a specialist, be hospitalized, or have lab or X-ray work, your doctor
will refer you to a provider or facility within the HMO system. Your doctor must
give authorization for those services to be covered by your HMO. In other words,
you must see HMO approved physicians and use HMO approved facilities or pay
the entire cost of the visit yourself.

Similar to Point-of Service (POS) and PPO's, HMO's have made arrangements
for lower fees with a network of health care providers and give their policyholders
a financial incentive to stay within that network.

You may have to pay some portion of the cost (co-payment) for each office or
hospital visit, such as $20 - $30 per doctor visit, regardless of what the services
cost. Also, some services such as emergency room, mental health and chemical
dependency services, may carry additional costs in a New York HMO health
maintenance plan.
Click on the link below to fill out a secure quote request form for a New York
HMO health insurance policy that provides excellent health insurance coverage
and services at an affordable cost. Or speak with one of our New York Health
Insurance specialists at (845) 426-0868 to discuss the features.
PPO Health Insurance Policy Features - New York
* Convenient access to quality health care
* Large and diverse network available of primary care physicians,
specialists, hospitals & clinics.
* Pay for services as they are provided
PPO Health Insurance Policy Overview - New York
You can see any health care professional in the network any time you
choose to make an appointment. You don't need referrals for specialists or
other services as you do in an HMO. You can see doctors or specialists
outside your PPO network, however, your portion of the costs will be higher.

You may have to pay some portion of the cost (co-payment) for each office
or hospital visit, such as $20 - $30 per doctor visit, regardless of what the
services cost. Also, some services such as emergency room, mental
health and chemical dependency services, may carry additional costs in a
New York PPO health insurance plan.
Click on the link below to fill out a secure quote request form for a New York
family or individual PPO health insurance policy that provides excellent
health insurance coverage and services at an affordable cost. Or you can
speak with our New York Health Insurance specialist at (845) 426-0868 to
discuss the features.
POS Health Insurance Policy Features - New York
* Preventive care emphasis
* Pays benefits for out-of-network care, but at a lower level
POS Health Insurance Policy Overview - New York

Less restrictive than an HMO or PPO, a (POS) or Point of Service plan lets you
see any licensed health care professional for anything covered by the insurance.
Care you receive from out-of-plan health care professionals is reimbursed, but
you must pay an often times much higher co-payment or deductible amount.
While you may choose to see a physician outside the network, if you don't
receive permission from your (PCP) primary care physician, you're likely to end
up submitting the bills yourself and receiving only a small reimbursement...if any.

Costs that exceed your deductible are covered by a co-insurance plan in which
you and the insurance company share the cost for services covered by the
policy.

Also, some services such as emergency room, mental health and chemical
dependency services, may carry additional costs in a New York POS health
insurance plan.
Click on the link below to fill out a secure quote request form for a New York
family or individual POS health insurance policy that provides excellent health
insurance coverage and services at an affordable cost. Or speak with one of
our New York Health Insurance specialists at (845) 426-0868 to discuss the
features.
Fee-for-Service or Major Medical Health Insurance Policy
(Family or Individual in New York)
Major medical health insurance provides benefits up to a high limit for most types
of medical expenses incurred, subject to a deductible. Once you meet the
deductible, our New York Major Medical Insurance plans pay a percentage of what
is considered the "Usual and Customary" charge for covered services. The
insurance company generally pays 80% of the Usual and Customary costs and
you pay the other 20%, which is known as co-insurance. If the insurance
company charges more than the Usual and Customary rates, you will need to pay
both the co-insurance and the difference.
With New York Major Medical Insurance plans you can choose your doctor and
any hospital for your medical services. You or your doctor send the bill to the
insurance company, which pays part of it. Usually, you have a deductible such as
$250 or more to pay each year before the insurer starts paying. The plan will pay
for charges such as medical tests and prescriptions as well as from doctors and
hospitals.
Major medical insurance coverages offer more choice of doctors (including
specialists, such as cardiologists and surgeons), hospitals, and other health care
providers than managed care plans, such as HMO, PPO, and POS. Major Medical
Insurance may not pay for some preventive care, such as check-ups, and is
usually a more expensive health insurance coverage than utilizing a New York
HMO, PPO, or POS plan.
Click on the link below to fill out a secure quote request form for a New York family
or individual Fee-for-Service / Major Medical health insurance policy that provides
excellent health insurance coverage and services at an affordable cost. Or speak
with our New York Health Insurance specialist at (845) 426-0868 to discuss the
features.
Learn more about the other types of Individual or Family Health Insurance
polices we offer in New York by clicking on a link below!
Learn more about the other types of Individual or Family Health Insurance polices
we offer in New York by clicking on a link below!
Managed Health Care Plans:
Fee-for-Service Health Plan:
Learn more about the other types of Individual or Family Health Insurance
polices we offer in New York by clicking on a link below!
Managed Health Care Plans:
Fee-for-Service Health Plan:
Learn more about the other types of Individual or Family Health Insurance
polices we offer in New York by clicking on a link below!
Managed Health Care Plans:
Fee-for-Service Health Plan:
Managed Health Care Plans:
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**The information, pictures, and other content in this website about particular
insurance services is only provided for informational purposes. Any decisions
regarding your insurance needs should be discussed with a licensed insurance
agent.
Edouard Insurance Agency, Inc.
70 South Main Street
Spring Valley, New York 10977
Rockland County, NY
(845) 426-0868
Toll Free: 1-800-776-0585
Fax: (845) 426-0632

Working to insure and
protect you since 1987!
EDOUARD
Insurance Agency
Health
Insurance
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