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EmblemHealth for Medicare Beneficiaries

EmblemHealth Medicare

     

4-star quality Medicare HMO Plan
Not sure of the ZIP code?
Use our Coverage Map. Have Questions?
Call us at 800-888-8888.

Understanding Medicare Insurance

This section gives you easy-to-understand information on Medicare coverage. And if you have questions, call us. We're here for you.  

What is Medicare Insurance?

Why Medicare Advantage?

Frequently Asked Questions


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The EmblemHealth Difference in Medicare Coverage

EmblemHealth offers the same value, affordable cost, benefits and great personal service New Yorkers have come to expect for more than 75 years. With our combination of experience, plan options and a large hospital and provider network, we offer everything you need in a Medicare plan. Learn more about what makes us unique and start getting the Medicare benefits you deserve. Let's begin a relationship you can count on to help you stay healthy, get well and live better.

Network Information

Care for the Caregiver

Health and Wellness

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Enroll In a Medicare Plan

You've looked at your health insurance options, and now you’re ready to enroll. We want to make the process as easy as possible for you. This section outlines your three EmblemHealth Medicare Advantage Plan enrollment options.


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Who to Contact if You Have Questions or Concerns

If you have any questions or concerns, you should contact:

  • EmblemHealth Medicare HMO Customer Service at 1-877-344-7364
    (TTY/TDD: 711), Monday through Sunday, from 8 am to 8 pm.
  • EmblemHealth Medicare PPO Customer Service at 1-866-557-7300
    (TTY/TDD: 711), Monday through Sunday, from 8 am to 8 pm.
  • EmblemHealth Medicare PDP Customer Service at 1-877-444-7241
    (TTY/TDD: 711), Monday through Sunday, from 8 am to 8 pm.
  • EmblemHealth Medicare Supplement Insurance Plans Sales at 1-866-287-7151
    (TTY/TDD: 711), Monday through Sunday, from 8 am to 8 pm.

There are also other ways to contact us. You can also contact Medicare directly about your health plan or prescription drug plan. Before you contact Medicare directly, we encourage you to call EmblemHealth Customer Service at the numbers listed above. EmblemHealth is responsible for resolving all of your issues related to your health plan and prescription drug plan coverage.



Disclaimers

HIP Health Plan of New York (HIP) is a HMO plan with a Medicare contract. Group Health Incorporated (GHI) is a PPO plan and a standalone  PDP with a Medicare contract. Enrollment in HIP and GHI depends on contract renewal. HIP and GHI are EmblemHealth companies.

All Medicare Advantage Plans and Medicare Prescription Drug Plans agree to stay in the program for a full calendar year at a time. Benefits, formulary, pharmacy network, premium and/or copayments/coinsurance may change on January 1 of each year. Each year, plans can decide whether to continue to participate with Medicare Advantage or Medicare Prescription Drug Plans. A plan may continue in their entire service area (geographic area where the plan accepts members) or choose to continue only in certain areas. Also, Medicare may decide to end a contract with a plan. Even if your Medicare Advantage Plan or Prescription Drug Plan leaves the program, you will not lose Medicare coverage. If a plan decides not to continue for an additional calendar year, it must send you a letter at least 90 days before your coverage will end. The letter will explain your options for Medicare coverage in your area.

*Medicare evaluates plans based on a 5-Star rating system. Star Ratings are calculated each year and may change from one year to the next.


The benefit information provided is a brief summary, not a complete description of benefits. For more information contact the plan. Limitations, copayments, and restrictions may apply. Benefits, formulary, pharmacy network, premium and/or copayments/coinsurance may change on January 1 of each year.

EmblemHealth Dual Eligible (HMO SNP) and EmblemHealth Dual Eligible (PPO SNP) plans are available to anyone who has both Medical Assistance from the State and Medicare. Premiums, copays, coinsurance, and deductibles may vary based on the level of Extra Help you receive. Please contact the plan for further details.


 

Y0026_124265r5 Approved 1/12/2014


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Last Updated 11/20/13

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