What’s new in 2022

Provider networks and plan administration

  • Value, Buy-up and High Deductible Health Plan (HDHP) Tier 1 and Tier 2 provider networks are changing, but we’re retaining nearly all of the in-network doctors and other healthcare providers that are available to you today

  • The third-party administrator (TPA) for Value and Buy-up plans will also be Northwell Direct who integrates with Brighton Health Plan Solutions (Brighton) to administer and manage claims processing and more.

Visit Northwell.edu/myMedical to learn more about the provider networks and plan administration.

Plan design changes

  • Fertility: Three-cycle maximum for infertility treatments and fertility preservation procedures will be replaced by a $45,000 lifetime maximum. Treatment received outside of Northwell Health Fertility is not covered.

  • Home healthcare and home infusion therapy: Covered only when using the Tier 1 Northwell Direct network. Plan members will be responsible for 100% of cost when using any outside providers. This does not apply to out-of-area plan participants.

  • Urology care: Deductibles will increase when not using the Tier 1 Northwell Direct network providers for urology care. Please see the deductible amounts per medical plan and tier below. This does not apply to OOA plan participants.
    • Value and Buy-up
      • Tier 2: $5,750 individual/$11,500 family
      • Out-of-Network (OON): $8,500 individual/$17,000 family
    • HDHP
      • Tier 2: $6,750 individual/$13,500 family

  • Hearing aid benefit: New benefit in 2022! Plan members are eligible for two hearing aids up to $5,000 every five years at Northwell Health Hearing Aid Dispensaries. Click here for a list of eligible locations.

Out-of-area (OOA)

  • Zip codes no longer considered OOA: Northwell offers OOA plans to team members based on geographical locations. As the Northwell Direct network has more extensive reach, more zip codes will no longer be considered OOA and will need to elect into the Value, Buy-up or HDHP for 2022 medical benefits coverage.

  • New OOA locations: In addition, with this change, these zip codes will now be considered OOA and will need to elect into the OOA Value, Buy-up or HDHP for 2022 medical benefits coverage.

Click here to view which zip codes are now in-area and OOA.

This program offers team members who are enrolled in Northwell Value, Buy-up, or High Deductible Health Plans (HDHP) the opportunity to earn a new maximum of $2,080 in paycheck credits, increased from $1,560 in 2021, in exchange for four healthy actions including the Health Risk Assessment. The four newest actions are:

  • Cultural sensitivity
  • Center for Wellness and Integrative Medicine
  • Pulmonary program
  • Lung cancer screening
  • Click here to view our updated 2022 Benefits Open Enrollment (OE) & medical plan provider networks and third-party administrator (TPA) transition Frequently Asked Questions.