EmblemHealth for Medicare Beneficiaries


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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

Moving from a Marketplace or SHOP Plan to a Medicare Plan

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The EmblemHealth Difference in Medicare Coverage

We’re New Yorkers too. In fact, we have been bringing quality health care coverage to the New York community for over 75 years. We live here and work here just like you do, so we understand how complex health care can be –that’s why we’re here to help. Learn more about what makes us unique to New York and start getting the Medicare insurance benefits you deserve.

Network Information

Care for the Family Caregiver

Health and Wellness

Neighborhood Care

Small Steps

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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.

Enroll Now

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 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.


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.

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, provider 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.


Rx Cost Calculator

Type in the names of the medications you take to calculate the costs.

Rx Calculator
Search for Medications

Find the medications you take on our formulary.

Search for Medications
Find a Pharmacy

There’s an EmblemHealth network pharmacy near you. Here’s how to find one.

Find a Pharmacy