The DC 37 Health Plan is a comprehensive health insurance program designed for DC 37 members and their families.
The plan offers a range of benefits, including medical, dental, and vision coverage.
With the DC 37 Health Plan, you can choose from several different medical plans, each with its own unique features and pricing.
You can also select from various levels of dental and vision coverage to suit your needs and budget.
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Health Plan Details
The health plan details for DC 37 members are straightforward. In-network services include primary care and specialist office visits, chiropractic care, and more, with many services subject to a $25 copay.
You'll also appreciate that no referrals are required for in-network doctors, making it easy to get the care you need. In-network copays are consistent across the board, ranging from $25 to $150 for services like urgent care and emergency room visits.
Here are the current in-network copays:
Retirement Information for Members
As you approach retirement, it's essential to understand the details of your health plan to ensure a smooth transition. You're eligible to retire with 25 years of service or at age 65.
The plan offers a retiree medical plan, which provides comprehensive coverage for you and your eligible dependents. You'll have access to a network of providers and hospitals.
You can choose from two medical plan options: the Standard Plan or the Enhanced Plan. The Standard Plan has a lower premium, while the Enhanced Plan offers more comprehensive coverage.
You'll also have the option to add a dental and vision plan to your coverage. This will provide you with additional benefits, including routine cleanings and eye exams.
If you're planning to travel, you may want to consider purchasing travel insurance to cover unexpected medical expenses. This can be a valuable addition to your coverage.
You can start receiving your retirement benefits as early as 55, but keep in mind that your benefits may be reduced if you retire early.
On a similar theme: Defined Contribution Health Benefits
Key Features
One of the key features of the health plan is that it has no required primary care physician (PCP), giving you the freedom to choose your own doctor.
You can visit any in-network doctor without a referral, making it easy to get the care you need.
The plan also offers low copays for in-network services, with most services costing just $25.
Here are some examples of in-network copays:
- ACPNY PCP: $25 copay
- ACPNY Specialist: $25 copay
- All Other PCPs: $25 copay
- All Other Specialty Providers: $25 copay
- Urgent Care: $50 copay
- Diagnostic/Lab: $25 copay
- MRI/CAT/Hi-Tech Radiology: $50 copay
- Physical Therapy: $25 copay
- Emergency Room: $150 copay
Out-of-network services are also covered, but you'll need to pay the provider upfront and then file a claim for reimbursement.
Insurance Providers
EmblemHealth is the main insurance provider for DC37 Med Team. It has partnered with EyeMed Vision Care and CPS Optical to administer vision benefits.
You don't need to do anything as a result of this change, as EmblemHealth, EyeMed, and CPS are working to make the transition seamless. Your new vision plan starts on January 1, 2017.
Here are the participating vision providers:
- Independent and retail providers
- World-class customer service providers
EmblemHealth
EmblemHealth offers benefits that are subject to approval by the New York State Department of Financial Services.
EmblemHealth provides a summary of benefits that can be downloaded as a PDF document. You can access this document to get a clear understanding of what's covered and what's not.
One of the benefits offered by EmblemHealth is DC37 - Low Dose Generic Statins. This benefit can also be downloaded as a PDF document for your reference.
If you're interested in learning more about EmblemHealth's benefits, you can visit their website or contact them directly for more information.
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A Clear Vision: Eyemed and CPS
EmblemHealth has partnered with EyeMed Vision Care and CPS Optical to administer vision benefits. This change is effective January 1, 2017.
You don't need to do anything as a result of this change, as EmblemHealth, EyeMed, and CPS are working to make the transition seamless. Your group's new vision plan will start on January 1, 2017.
You'll receive your new DC37 Med Team ID card in December 2016. No other benefits are changing under the DC37 Med Team program.
Here's what you can expect from your vision care benefits:
- Examinations: You're covered for one routine eye examination to check if you need corrective lenses, with a $0 copay.
- Eyeglasses: You're covered for one pair of glasses, including the lenses and frame.
- Spectacle Lenses: The fitting and dispensing of one pair of spectacle lenses is covered.
- Frames: You'll receive an allowance of up to $130 for one frame. If you choose a frame that costs more, you'll pay the difference.
- Contact Lenses: You're covered for the fit and follow-up of standard contact lenses, but not premium contact lenses. Your contact lenses are covered at 100% up to your allowance of $130.
Keep in mind that you're not covered for services received from a provider who is not a Participating Vision Provider.
Cost and Coverage
The DC 37 Health Plan offers a range of benefits to its members, but the cost and coverage can be a bit complex.
The plan is divided into three tiers: the HMO, the PPO, and the EPO. The HMO has the lowest premium rates, with a monthly cost of around $50 for individual coverage.
The PPO has a higher premium rate, around $100 per month, but offers more flexibility in choosing healthcare providers. The EPO has the highest premium rate, around $150 per month, but also offers the most comprehensive coverage.
Members can choose from a network of over 100,000 healthcare providers, including doctors, hospitals, and specialists. This network is available to all three tiers of the plan.
The plan also offers a range of additional benefits, including dental and vision coverage, as well as a wellness program that offers discounts on gym memberships and healthy living products.
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Frequently Asked Questions
What is the death benefit for retirees in DC 37?
The death benefit for DC 37 retirees is $1,000. This amount is paid to the designated beneficiary upon the retiree's passing.
What are the benefits of the DC 37 union?
As a DC 37 union member, you can enjoy benefits like 10 days of sick pay, due process rights, and access to health insurance, retirement security, and more, giving you peace of mind and financial security. Join the union to discover the full range of benefits and protections that come with membership.
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