ABOUT US

Who We Are

Quality Health Plans of New York, Inc. (QHPNY) is a physician-owned, Medicare Advantage HMO committed to providing our members the highest caliber, most effective and innovative programs in the healthcare industry. In order to accomplish this, we have gathered substantial input from the local provider community, and seek to preserve the independence of the physician-patient relationship in determining medical care.

Our style of management empowers primary care physicians to use their professional experience to coordinate and ensure the best possible care for each patient. In other words, QHPNY allows its team of dedicated physicians and healthcare professionals to focus on what is most important: providing exceptional quality care and achieving high levels of patient satisfaction.

We focus on preventive rather than reactive care. We concentrate on keeping our patients healthy by encouraging them to have routine check-ups, annual immunizations and hearing and vision examinations, as well as providing care when they are sick or injured.

What We Do

Use of healthcare services for primary and specialty physicians traditionally focus on patients choosing their own access point. Quality Health Plans of New York’s (QHPNY) healthcare model allows the primary care physician to schedule each patient as frequently as needed so that the patient’s care is closely monitored. Patients may schedule visits more frequently, and our research indicates that 20 percent will do so. Specialist visits and services are also coordinated through the patient’s primary doctor.

QHPNY delivers a broad range of comprehensive health services, and we ensure that our patients have access to all covered Medicare benefits. Contracted physicians and healthcare providers are expected to be available 24 hours a day, seven days a week, whether it is during office hours, after hours or via service coverage. Patients in and out of the defined service area may also access hospital emergency room services 24 hours a day, seven days a week for urgent/emergent care.

Commitment to Quality

Quality Health Plans of New York, Inc. (QHPNY) believes that quality healthcare starts with the provider-patient relationship. We carefully offer contracting opportunities to the highest caliber of physicians and hospitals. In addition, we have a formal Quality Assurance Team that monitors the quality of our network and providers.

It is not uncommon for most physicians and patients to think of healthcare in terms of treatment rather than prevention. At QHPNY, we focus on keeping our patients healthy by encouraging routine check-ups, annual immunizations, early intervention encounters, and hearing and vision examinations. Of course, we also provide the best possible care when patients are sick or injured.

QHPNY is committed to bringing quality, affordable, convenient, and easy-to-use healthcare to all of our patients

Our Services

Quality Health Plans of New York offers six different Medicare Advantage Plans; one is right for you.

  1. Medicare Advantage Plans

    Medicare Advantage Plans are the one of the best deals in healthcare.  You have all the benefits and protections you currently enjoy as a Medicare Beneficiary but more.  You’re out-of-pocket expenses can be considerably lower and you get some benefits not normally covered by Original Medicare.

  2. Medicare Special Needs Plans

    Quality Health Plans of New York offers two types of Medicare Special Needs Plans (SNPs).  These include two plans for those with diabetes or cardiovascular disorders and one plan for those eligible for both Medicare and Medicaid.  Each plan has a benefit structure specifically designed to meet the needs of its target population.

  3. Prescription Drug Coverage

    You are probably accustomed to paying a monthly premium for prescription drug coverage, something like $35 per month.  Not so with our Medicare Advantage Plans.  With these plans your prescription drug coverage comes bundled with your coverage with no additional plan premium.  Sound good?  It get better.  Some of our plans even offer coverage in the Gap or Doughnut Hole for preferred generic drugs.

  4. Medication Therapy Management

    This is a free and voluntary program that helps you get the most of your medications.  Our MTM Program, administered by Medication Management Systems, Inc., allows access to medical professionals that will work with you and your doctor to make sure you are getting the full benefits from the medications you are taking and that you have all your questions answered. Quality Health Plans of New York has developed specific criteria using the general guidelines provided by CMS to enhance the care of our Medicare MTM members.

Our Vision

Quality Health Plans of New York, Inc. (QHPNY) is a physician-owned, Medicare Advantage HMO committed to providing our members the highest caliber, most effective and innovative programs in the healthcare industry.

In order to accomplish this, we have gathered substantial input from the local provider community, and seek to preserve the independence of the physician-patient relationship in determining medical care.