Empire Plan Programs and Services

Here are some of the benefits your employees will enjoy if your agency participates in The Empire Plan.

For each program's provider directory, click the links below.

Medical/Surgical Program

• The Empire Plan works with a wide range of participating providers including medical/surgical providers, laboratories, outpatient surgical locations, cardiac rehabilitation centers, urgent care centers and orthotic/prosthetic devices networks.
• Enrollees have access to a customized website to track their medical/surgical claims and history, print explanations of benefits (EOBs), create personalized provider directories and much more.

Hospital Program

• About 97% of hospitals nationwide are in-network with The Empire Plan. This is the largest hospital network available in the United States.
• Network coverage is also available at select New York hospital-based ambulatory surgical centers and hospital-owned urgent care centers.

Mental Health and Substance Use Program

• Enrollees have coverage for medically necessary inpatient and outpatient mental health and substance use treatment through a network of participating providers. Medically necessary services out of network are also covered.
• Enrollees have guaranteed access to network benefits if they call the Clinical Referral Line to find a provider and arrange care. (Call 1-877-7-NYSHIP toll-free and choose option 3 for the MHSU Program, then select option 3 from the MHSU Program menu.)
• The MHSU website also provides confidential online access to a provider/facility directory, educational and screening materials, disease management programs, and claims and coverage information.

Prescription Drug Program

• Enrollees have access to a wide variety of pharmacies, including pharmacies participating in the vaccine network and 24-hour service pharmacies.
• Mail-order prescriptions are also available online.

Nonparticipating Providers

• If an enrollee's primary insurance coverage is The Empire Plan and they use a nonparticipating provider that is part of the MultiPlan group, their out-of-pocket expenses will usually be reduced.