NYC and Surrounding Areas Largest Health Insurers

Crain’s New York Business released its ranking of NYC’s largest health insurers, ranked by the number of enrolled NYC members.  Practice owners always a multifactor decision on which, if any, insurance plans to become participating providers with – what the pay rate is, what the turnaround time for payment is, the complexity of getting authorizations etc., and their degree of penetration in the marketplace where you practice.

Below is a list of the top 10, ranked from largest to smallest  in the 5 boroughs of NY, Nassau, Suffolk, Westchester, and northern NJ counties, compiled from Crain’s as well as some commentary on their growth.
1) Empire BC/BS -4M + members, 14, 000 participating primary care physicians
2) United Healthcare- 3.6M+ members, 85,000+ participating primary care physicians
3) Aetna – 1.9M+ members, 17,000+participating primary care physicians
4) HealthFirst – 1M+ members, 18,000+ participating primary care physicians
5) GHI – 983,000 members, 14,000+participating primary care physicians
6) HIP – 708,000 members, 11,418 participating primary care physicians
7)Cigna Healthcare 700,000 members, 3,700 participating primary care physicians
8)Fidelis Care New York – 580,000 members, 8,600 participating primary care physicians
9)Health Plus Amerigroup – 475,000 members, 10,403 participating primary care physicians
10)MetroPlus Health Plan – 467,000 members, 3,900 participating primary care physicians
Please note that the parent or controlling company of Aetna and Fidelis, the parent company of Empire BCBS and Health Plus Amerigroup, and GHI and HIP  are the same.  Healthfirst recently acquired Neighborhood Health Partners. In NYC specifically, Fidelis increased its city membership by 17.2% and  Aetna has increased its NYC market share by 8.6%

 

 

 

 

 

 

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