Insurance Information

When you’re coping with a cancer diagnosis, insurance may be the last thing you or your loved ones want to deal with, but it’s important to understand your options. Our insurance specialists are here to help you make sense of your insurance and payment questions — whether you are considering coming to us as a new patient or you are already in our care.

Health Insurers Who Provide Coverage at MSK

Certain plans from the following insurance companies have relationships with us (and all of our doctors). Please review this list carefully. Call us if you have questions or need help understanding. Insurance companies offer many different types of plans, and some may not include us.

Even if you don’t see your insurance plan listed here, or you don’t have insurance, we encourage you to call us. There may be other ways we can help, for example, through our Financial Assistance program.

Questions?

If your question is about insurance only, please call us at 646-497-9176, Monday through Friday, 8:00 am to 5:00 pm ET (closed between 12:30PM-1:30PM). If your question involves insurance and a bill you received from us, please call us at 646-227-3378, Monday through Friday, 8:00 am to 5:00 pm ET (closed between 12:30PM-1:30PM).

Before contacting your insurance company, you may find it helpful to review Questions to Ask Your Insurance Company.

Aetna

Memorial Sloan Kettering is an in-network provider with Aetna HMO, POS, and PPO plans. Aetna does not include us in any of the plans you can purchase through the insurance exchanges or through Medicare. Please ask your insurance if you need a one-time referral.

Blue Cross Blue Shield

In New York State

Memorial Sloan Kettering is an in-network provider with Empire Blue Cross Blue Shield (Wellpoint) of New York HMO, EPO, PPO, and POS plans, with the following exceptions:

  • Empire Blue Cross Blue Shield does not include us in any of the plans you can buy through the insurance exchanges.
  • Memorial Sloan Kettering is not an in-network provider for Empire’s Medicare Managed Care plan known as Mediblue).
  • The Empire Indemnity Plan provides limited coverage for our services.

In New Jersey
Memorial Sloan Kettering is an in-network provider with some Horizon Blue Cross Blue Shield of New Jersey plans for individuals, families, and small businesses. For example, the PPO plan is in-network with our Manhattan locations. 

Horizon Blue Cross HMO is only in-network with our Basking Ridge facility. It does not allow access to our Manhattan or other New Jersey facilities.

Horizon Blue Cross PPO is in network with our Basking Ridge and Monmouth facilities as well as with our Manhattan facilities.

OMNIA Plans Tier I EPO based plan policy is only in-network with our Basking Ridge site and does not allow access to our Manhattan sites. Tier II EPO is in-network with our Manhattan sites if it is a blue-card plan (there would be a suitcase logo indicating PPO on the front of the card).

Other plans may only be in-network at our Basking Ridge or Monmouth locations.

Outside New York State and New Jersey
Some, but not all, Blue Cross Blue Shield plans outside of New York and New Jersey include Memorial Sloan Kettering as an in-network provider. Contact your insurance to find out if your plan provides in-network access to Memorial Sloan Kettering.

CIGNA

Memorial Sloan Kettering is an in-network provider with CIGNA’s HMO, POS, and PPO plans. CIGNA does not include us in any of the plans you can buy through the insurance exchanges.

  • If you are a New York State resident: Please ask your insurance if you need a one-time referral.
  • If you live outside of New York State: Please ask your insurance if you have in-network access to Memorial Sloan Kettering.

EmblemHealth (which includes GHI & HIP)

Memorial Sloan Kettering is an in-network provider with EmblemHealth’s PPO, EPO, POS, and HMO plans as well as their Enhanced Care Prime Network, which supports Medicaid Managed Care and Child Health Plus plans. Memorial Sloan Kettering is also in-network with the New York State Essential Emblem Health plan which can be purchased on the insurance exchange. Emblem Health does not include us in any of its Medicare plans. You must bring a referral from your Emblem primary care doctor to your first appointment. 

Empire Blue Cross Blue Shield Health Plus

Formerly known as Health Plus Amerigroup, Empire Blue Cross Blue Shield Health Plus is an in-network provider with Memorial Sloan Kettering. You will need a one-time referral from your primary care doctor.

HealthSmart

Memorial Sloan Kettering is an in-network provider with HealthSmart’s Accel, HSPC, and HPO networks.

Health Republic Insurance of New Jersey

Memorial Sloan Kettering is an in-network provider with Health Republic Insurance of New Jersey for plans you can purchase on the insurance exchanges. These plans cover individuals, families, and small businesses. You will need a one-time referral from your primary care doctor. This plan will no longer operate in 2017.

Medicaid

Memorial Sloan Kettering is an in-network provider with Medicaid NY Emblem Health (formerly known as HIP) and Medicaid NY Empire Blue Cross Blue Shield HealthPlus (formerly known as Amerigroup). You will need a one-time referral from your primary care doctor.

MagnaCare

Memorial Sloan Kettering is an in-network provider for all MagnaCare health plans except those products you can buy through the insurance exchanges.

Multiplan/Beech Street/PHCS

Memorial Sloan Kettering is an in-network provider with some Multiplan/Beech Street/PHCS plans. Contact your insurance carrier to find out if your plan provides in-network access to Memorial Sloan Kettering.

New York State Employee Health Insurance Plan (Empire Plan)

Memorial Sloan Kettering is an in-network provider for New York State employees who have enrolled in UnitedHealthcare’s Cancer Resource Services. If you have the Empire Plan, you should call Cancer Resources Services at 866-936-6002 to verify and enroll in this coverage.

Oxford

Memorial Sloan Kettering is an in-network provider with Oxford’s Freedom and Liberty plans as well as the Metro Plan (which is only offered to small business groups and no longer offered as individual plans). Please confirm with your insurance if you need a one-time referral. Note: Oxford’s Medicare Managed Care plan — Secure Horizon — does not include Memorial Sloan Kettering as an in-network provider. Oxford does not include us in any of the plans you can buy through the insurance exchanges.

QualCare

Memorial Sloan Kettering is an in-network provider with QualCare’s PPO and HMO/POS network.

TRICARE

Hospital and physician services at Memorial Sloan Kettering are covered by TRICARE. You are responsible for co-insurance and deductible costs.

UnitedHealthcare

Memorial Sloan Kettering is an in-network provider with UnitedHealthCare’s HMO, POS, and PPO plans. Please confirm with your insurance if a one-time referral is needed.

UnitedHealthCare’s Medicare Managed Care plan does not include Memorial Sloan Kettering as an in-network provider.

United does not include us in any of the plans you can buy through the insurance exchanges.

World Trade Center Health Program

Memorial Sloan Kettering is an in-network provider with the World Trade Center Health Program.

Other Coverage Options

We have agreements with several insurance companies that may provide additional coverage for cancer patients. These benefit programs include:

  • AXA Assistance USA
  • Beech Street
  • Integrated Health Plans
  • National Health Administrators
  • National Preferred Provider Network
  • UnitedHealthcare’s Cancer Resource Services
  • United Resource Network
  • Veterans Choice Program

Health Insurance Exchanges

We understand that there may be many complexities involved with insurance coverage purchased through the health exchange network of the Affordable Care Act. We’re here to help. If you have questions about how your care will be covered by an insurance provider, or need help navigating a change in coverage, please call us at 646-227-3378; if you are not a resident of New York, you can call us at 866-248-1274. Our team is here to listen to your concerns and assist you in any way we can. We want our care to be as accessible and affordable for as many people as possible.

Multiple Insurance Plans

If you are covered by more than one insurance plan, you will want to determine your benefits from both plans. First, you need to determine which one is your primary insurance provider by contacting your employee benefits office or your insurance carriers. After you find out which is your primary insurance provider, you should then contact your insurance carrier to determine if you have access to Memorial Sloan Kettering.

How We Help

If you’ve already met with an MSK physician and you need help with insurance, we may assign a case manager to advocate for you with your insurance company. Sometimes a carrier that has denied coverage of a treatment plan recommended by our doctors will revise its decision. Your MSK doctor’s office can put you in touch with our Case Management Department.

Prescription Coverage 

Your medical insurance is not necessarily the same thing as your prescription insurance. It’s possible that even though you have medical insurance, you may not have prescription insurance, or it may be different. 

Specific plans from certain insurance companies have relationships with Memorial Sloan Kettering and our doctors. Insurance companies offer many types of plans, and some may not include us.

If you have an active pharmacy card, please bring it with you to your next visit. For more information on medical and pharmacy coverage, see Questions to ask your Insurance Company.

Questions about your Prescription Coverage?

Call us at 646-888-1500 and we will be happy to help.

Usual, Customary & Reasonable Fees

Every insurance carrier has an established payment rate for each test, procedure, and medical service. The rates are what the insurer has decided are appropriate for these services in New York City. Insurers have different ways of deciding what is usual and customary.

Our charges may be different from an insurer’s rates due to the high level of care we provide to our patients. If you only have out-of-network benefits, you are responsible for paying the difference between Memorial Sloan Kettering’s charges and the carrier’s usual and customary rates, in addition to your co-insurance and deductible costs.

Please contact your insurance company’s customer service representative to verify your out-of-network benefits and find out what your financial responsibility will be.