Plan Options


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Alternative Funding Arrangements

EmblemHealth offers conventional and alternative funding arrangements and will consider special funding arrangements as requested by prospective customers, including ASO self-insurers, contingent upon group size.

What type of plan are you looking for?

PPO Plans
Provide In- and out-of-network benefits with no referrals required.

EPO Plans
Provide in-network benefits with no referrals required.


PPO Plans

PPO Overview

Plans with several cost-sharing options

In- and out-of-network benefits

Access to more than 106,000 physicians and other health care professionals at nearly 172,000 locations in the tristate area in addition to a nationwide network of practitioners

InBalance PPO Overview

Plans with several cost-sharing options

In- and out-of-network benefits

An affordable plan with cost-sharing features

Access to more than 106,000 physicians and other health care professionals at nearly 172,000 locations in the tristate area in addition to a nationwide network of practitioners

ConsumerDirect PPO Overview

First dollar coverage for preventive care

An affordable plan with cost-sharing features for other services

Coinsurance may also apply

In- and out-of-network benefits

Access to more than 106,000 physicians and other health care professionals at nearly 172,000 locations in the tristate area in addition to a nationwide network of practitioners

Optional Health Savings Accounts (HSA) and Health Reimbursement Arrangements (HRA)

EPO Plans

EPO Overview

Plans with several cost-sharing options

In-network only coverage

Access to more than 106,000 physicians and other health care professionals at nearly 172,000 locations in the tristate area in addition to a nationwide network of practitioners

InBalance EPO Overview

Plans with several cost-sharing options

In-network only coverage

An affordable plan with cost-sharing features

Access to more than 106,000 physicians and other health care professionals at nearly 172,000 locations in the tristate area in addition to a nationwide network of practitioners

ConsumerDirect EPO Overview

An affordable plan with cost-sharing features for other services

In-network only coverage

Access to more than 106,000 physicians and other health care professionals at nearly 172,000 locations in the tristate area in addition to a nationwide network of practitioners

Optional Health Savings Accounts (HSA) and Health Reimbursement Arrangements (HRA)

CompreHealth EPO Overview

No copays for kids for office visits and diagnostics available

No copay for generic drugs available

In-network only coverage

Includes preventive dental coverage

Convenient physician group practices and individual practitioners

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