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Cost & Coverage

As a Base (Catastrophic) health plan member, your first 3 visits to your primary care doctor are covered at no cost and you'll receive free coverage for preventive health visits to keep you and your family healthy. For all other services, such as your 4th visit to your primary care doctor, care provided by a specialist or emergency care, you are responsible for paying out of your pocket until you meet your deductible. Once you reach your deductible, your care is covered in full for the remainder of the year.

View a Summary of Benefits & Coverage

View a Contract & Other Legal Information for Prospective Members

Embedded Pediatric Dental

In compliance with New York State mandates, all our medical plans include low-cost pediatric dental coverage for those under age 19. You can choose to exclude pediatric dental coverage, while maintaining comprehensive coverage for adults, if you already have coverage from another health plan.

A Great Provider Network

All of our plans give you access to top-quality doctors, hospitals and pharmacies.

Exclusive Member Benefits

NEW! VitalizeSM, powered by Virgin Pulse, is your digital home base for health and wellbeing. Get access to tools and support to make small, everyday changes in the areas you want to improve most.

As our member, you'll enjoy additional perks including:

  • No referrals needed for specialist appointments
  • Discounts with Perks 4 U®
  • 24/7 Nurse Call Line
  • Access to 6,000+ health topics
  • And more!

Univera Dental Rewards

Go to the dentist and receive up to $100 for getting your teeth cleaned. It's really that easy. You don't even have to have dental coverage through Univera Healthcare. Just provide proof that you or your spouse/domestic partner went to the dentist for your annual cleanings, and we'll pay you up to $100 ($50 per person) to use as you wish.

Need Help?

We can help you get coverage.

Call: 1-888-679-71661-844-829-8513 (TTY 711)

Monday - Thursday: 8 a.m - 5:30 p.m
Friday: 9 a.m. to 5:30 p.m.

Monday - Thursday: 8 a.m. to 7 p.m.
Friday: 9 a.m. to 7 p.m.

Closed: New Year’s Day, Memorial Day, Labor Day, Thanksgiving Day, Day after Thanksgiving, Christmas Eve, Christmas Day

Estimate Medical Costs

As a member you will have access to our Estimate Medical Costs tool to compare out-of-pocket costs for hundreds of procedures across many different treatment categories.