Our 2020 Plans

2020 Medicare Advantage Plans

Important Notice on MAPD HMO Plan Termination Effective March 1, 2020

Effective February 29, 2020, Quality Health Plans of New York (QHPNY) will terminate its contract with the Centers for Medicare and Medicaid Services (CMS).

Quality Health Plans of New York won’t offer Medicare plans after February 29, 2020. This means coverage through Quality Health Plans of New York will end February 29, 2020.

It has been our honor to serve you. Quality of Health Plans of New York would like to thank you for the opportunity and sincerely apologizes for any inconvenience this may cause.

For more information members should refer to the notices recently mailed or call Customer Service at 1 (877) 233-7058 (TTY/TDD: 711). Until March 31st, you can call us 7 days a week from 8:00 a.m. to 8:00 p.m. and from April 1 to April 30th, you can call us Monday through Friday from 8:00 a.m. to 8:00 p.m.

You may also call 1-800-MEDICARE (1-800-633-4227). Tell them your plan isn’t going to be offered after February 2020 and you want help choosing a new plan. This toll-free help line is available 24 hours a day, 7 days a week. TTY users should call 1-877-486-2048.


Effective November 19, 2018, the Centers for Medicare and Medicaid Services (CMS) imposed intermediate sanctions on Quality Health Plans of New York (QHPNY). This means that QHPNY can not accept new enrollments into our plan and/or market to enrollees, at this time.

There were four reasons QHPNY was sanctioned:

  1. Failing to meet CMS financial requirements.
  2. Failing to file these financial statements timely.
  3. Failing to pay 95% of out-of-network providers within 60 days.
  4. Failing to notify out-of-network providers of claim denial decisions within 60 days after receipt of service requests.

 

If you are a current QHPNY member, the benefits you have as a member of your current plan will not be affected in any way and will continue while QHPNY is sanctioned.  You still have access to our providers and pharmacy network and coverage for medical services and drugs on our formulary.

QHPNY is working diligently to resolve these issues as quickly as possible and we apologize for the inconvenience.

2020 Advantage Health LI

A Chronic Illness Special Needs Plan for residents of Nassau and Suffolk. Has a great benefit in the Part B Premium Giveback of $300/year.

2020 Advantage Health NYC

This is our chronic illness special needs plan for residents of Queens and Richmond Counties. There is no plan premium.

2020 Advantage Value One NY

Designed specifically for those enrolled in New York State Medicaid. Benefits are coordinated so you have very few out-of-pocket costs. Available in all 4 counties of our service area.

2020 Advantage Silver NY

This is our most popular plan available to residents of Nassau and Suffolk. Members love the Part B Premium Giveback of $120/year.

2020 Advantage Silver NY City

A really generous benefit array for $0 plan premium but only Medicare Beneficiaries residing in Richmond and Queens Counties are eligible.

2020 Advantage Premium NY

This is our premium plan and is available in all 4 counties in our service delivery area. There is an $78/month plan premium for this plan which is rich and generous in services and benefits.