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Considering EmblemHealth?
Please contact us or call EmblemHealth sales at
1-877-411-3625
Pharmacy Benefits
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InBalance EPO (2 - 50)
Plan Overview
EmblemHealth InBalance EPO gives members access to the same great doctors, hospitals, and in-network-only benefits as EmblemHealth EPO. Cost-sharing measures may allow employers to keep their group's premium payments down, but more services are subject to deductible and coinsurance than with the EPO plan.
Our InBalance EPO Plan Keeps the Care In Network, but Adds
Cost-Sharing Requirements
Key Features*
No copay for kids for in-network office visits or diagnostic tests
Preventive services covered in full in network
Deductible and coinsurance apply to hospital services, in-office surgical procedures and outpatient diagnostic radiology procedures
Most other office visits require just a copay
Open formulary for all FDA-approved medications
More Features
Discounts on weight-loss programs, laser vision, acupuncture and more**
Employee Assistance Program (EAP) phone line and Nurse Advice line
available 24/7
Quality Doctors and Hospitals
Access to the EmblemHealth National Network, featuring:
Many of the tristate area's leading physicians and other medical practitioners
Leading acute care hospitals, including Montefiore Medical Center, North Shore-LIJ Health System, NY Presbyterian Hospital System, Memorial Sloan-Kettering Cancer Center and Albany Medical Center
Physicians and hospitals across all 50 states
Member Convenience
Members can securely manage their health information on our Web site.
Members can also search for a doctor as well as view and e-mail an image of their temporary ID card using their mobile phone.
Physician Group Practices Offer Convenient Care
In addition to individual doctors, our network features physician group practices that enable multiple practitioners to work together on a single instance of care. The practices combine the personal experience of a doctor’s office with the leading-edge technologies you’d expect from a hospital. Other benefits include:
A full range of health services, from preventive and primary care to specialty care — often in one location
Extended evening and weekend hours and same-day appointments at many locations for routine medical care, with select locations also offering urgent
care centers
*Some services are subject to preauthorization.
**EmblemHealth cannot ensure that a particular vendor will remain in the program. These programs are not part of EmblemHealth PPO, and, therefore, are not underwritten by Group Health Incorporated (GHI).
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