
Please contact your broker or EmblemHealth sales at
1-877-411-3625
Drug Lookup
See covered drugs in our formulary.
Find a Pharmacy.
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For plans that contain pharmacy coverage. Check the applicable benefits design or the certificate of insurance for more information.
We respect that different groups and individuals have different needs. That's why we offer CompreHealth EPO for large groups (51+) in the metropolitan area. EmblemHealth CompreHealth EPO offers:
A quality network of established, multi-specialty physician group practices delivering coordinated care at affordable prices.
A tiered rate structure to fit your needs.
Our most affordable plan for experience-rated groups—with lower premiums and limited out of pocket costs.
No copay for children for in-network office visits and diagnostic services.
A wide variety of cost-sharing options.
Physician group practices, including Manhattan's Physician Group, Preferred Health Partners, Queens-Long Island Medical Group and Staten Island Physician Practice, as well as practices run by leading institutions including Montefiore Medical Group and North Shore L.I.J. Faculty Practice.
Coordinated care between primary-care physicians and specialists.
Access to preventive care and wellness programs plus non-traditional benefits, such as alternative medicine, acupuncture, nutritional counseling, and massage therapy.
A full range of health services—primary care, preventive care, specialty care—all at one location. Care is provided by a dedicated team of health care practitioners who work in close collaboration.
No referrals for in-network specialist care.
Same day appointments with most doctors.
CompreHealth health care practitioners work in close collaboration so members receive needed care faster. It's easy to schedule visits and care with multiple services under one roof.
Reduced paperwork.With CompreHealth EPO there are no claims to file. Our network providers do the work for you.
24/7 customer service.Provider listings, eligibility, benefits and more are available at www.emblemhealth.com, or by calling our automated phone system.
At EmblemHealth, we understand the things that matter to members about their health care coverage—including respect for their time, intelligence, and money. At EmblemHealth, we build our plans around your expectations. CompreHealth EPO members don't want to sacrifice quality for affordability. They want to keep things simple and hassle-free. The EmblemHealth CompreHealth coordinated care option does just that.
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| Services | in-network |
|---|---|
| Annual Physical Check-up | Office Copayment |
| Preventive Mammography, Pap Smear, Prostate Screening | Covered in Full |
| Well-Baby and Well-Child Care | Covered in Full |
| Inpatient Hospital Services | Hospital Copayment |
| Skilled Nursing Facility Care | Covered in Full |
| Hospice Care - Inpatient and Outpatient | Covered in Full |
| Ambulatory Surgery Facility | Ambulatory Surgery Copayment |
| Home Health Care | Covered in Full |
| Chiropractic Care | Specialist Office Visit Copayment |
| Diagnostic Lab and Radiology | Included in Hospital or Office Visit Copayment |
| Emergency Room Facility | ER Facility Copayment |
| Inpatient Mental Health Care | Hospital Copayment May Apply |
| Outpatient Mental Health Care | Specialist Office Visit Copayment |
| Inpatient Detox | Hospital Copayment |
| Outpatient Chemical Dependency Care | Specialist Office Visit Copayment, not to exceed $25 |
| Refractive Eye Exam Frames and Lenses | Specialist Office Visit Copayment, $45 Copayment |
| Prescription Drugs | Prescription Drug Copayment if selected |
| Preventive Dental (see details) |
$5 exam; $10 cleaning; $5 fluoride treatment for kids |