Medical Benefit for Greater New York Members

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Reinstating Member Cost Share for COVID-19-Related Services

During the federal COVID-19 public health emergency (PHE), the Benefit Funds temporarily waived certain cost sharing for COVID-19-related visits and diagnostic services to help ensure that you had access to medical services during this challenging time.

Effective January 1, 2024, the Benefit Funds are reinstating this previously waived member co-pay for COVID-19 related visits and diagnostic service:

  • $75 co-pay for emergency room visits

Please remember to show your Health Benefits ID card to your doctor for applicable co-pays.

Your medical benefit gives you access to more than 20,000 providers across New York City, Westchester and Long Island, 14,000 of whom are affiliated with our Member Choice network hospitals. If you live outside New York City, Westchester and Long Island, you choose your providers from the Aetna Choice POS II network. All of these providers accept the Benefit Fund’s payment for most services, and there are no referrals and no out-of-pocket costs or deductibles for covered services. You also receive a dental benefit.

Remember — if you are referred to non-participating providers, including physicians or services such as anesthesiology, radiology or lab procedures — you could face high out-of-pocket costs. Always check to make sure your provider is in the Benefit Fund’s network.

For lab and radiology services, make sure you use a participating provider.

Who Is Eligible?

Eligibility Class I and II — Family Coverage

Eligibility Class III — Not covered for this benefit

Not sure what wage class you are?

Check the front of your Health Benefits ID Card, or read a further explanation.

Greater New York members employed by New Jersey employers receive healthcare benefits through Aetna. Call (646) 473-9200 for questions about your benefits.

Additional Resources