Individual & Family Plans - Excellus Prospect

Health insurance coverage for Metal level plans (Bronze, Silver, Gold, and Platinum) are essentially the same. The difference is how much you choose to pay each month as an upfront cost. A lower monthly payment (Bronze) usually means a higher cost of care when you go to a doctor. A higher monthly payment (Platinum) generally means that you’ll pay less for each visit to the doctor.

The Essential Plan is a free or low-cost option for people who meet certain income eligibility guidelines. The plan costs $0 or $20 for eligible individuals, but offers the same essential benefits as other health plans. It has no deductible, so the plan starts paying for your health care right away, and you get free preventive care like routine doctor exams and screenings to keep you healthy.

Blue Choice Option and HMOBlue Option are Medicaid programs sponsored by New York State. They provide very low-cost health insurance for individuals and families who are eligible. You will have a Primary Care Provider (PCP) who will provide most of your care at little or no cost, and you will have access to a network of more than 13,000 other doctors, urgent care centers, hospitals and specialists when needed.

Free or low-cost coverage for children. Depending on your family’s income, your children up to age 19 may qualify for free or low-cost health insurance coverage sponsored by New York State.

Unless you experience certain life changes during the year, you can only buy, change, or renew your Individual & Family plan between November 1 and January 31. If you are eligible for Medicaid, Child Health Plus, or the Essential Plan, you can enroll at any time during the year.

When you experience certain life events, you may qualify to buy or change your health insurance coverage outside of the annual open enrollment time period. Those events include things such as having a baby, getting married or divorced, moving from one service area to another, or losing coverage from your employer. If you have a special enrollment period, in most cases you have 60 days to enroll in a plan.

Enjoy the convenience of filling your prescriptions by phone or online and having them delivered to your home. You can save up to 33% on prescriptions and order up to a 90-day supply of medication at one time.

Telemedicine, powered by MDLIVE, allows you to see a board-certified doctor by phone or video on your schedule, anytime, anywhere including from your own home.

Our preventive health program can help you stay healthy and reduce your risks for certain illnesses. Our members have access to health screenings, interactive tools and programs for weight management, improved fitness, getting rid of lower back pain, quitting smoking, and more.

Healthcare coverage wherever you go within the United States. BlueCard gives you access to a nationwide network of doctors and hospitals when you travel. Emergency care is covered anywhere in the world.

Enjoy the convenience of filling your prescriptions by phone or online and having them delivered to your home. You can save up to 33% on prescriptions and order up to a 90-day supply of medication at one time.

Our licensed, clinical pharmacists are available to answer medication-related questions from members and their physicians.

When you need a prescription, you may be able to cut down on your health care costs. Generic drugs are safe, effective, and approved by the FDA. They just cost you less.

The cost of prescription drugs varies widely, even for medications that are used to treat the same condition. Our medication guide for members was developed to help you and your doctor select lower cost options that are just as effective, saving you money.