EmblemHealth Medicare Advantage HMO Plan

With the EmblemHealth Medicare Advantage HMO plan, you get comprehensive coverage, just like with the HIP Prime HMO plan — but with an additional enhanced pharmacy benefit. And, you save with lower copays while your premium contribution stays the same.

You get coverage for your medical, preventive care, outpatient and hospital services. Your doctor visits and hospital services are covered with $0 copays. You also have 3-tier pharmacy coverage with $0 copays for generic and brand-name formulary drugs; while non-formulary drugs are covered with a $40 copay.

These benefits are neither offered nor guaranteed under contract with the FEHB Program, but are made available to all enrollees and family members who become Members of EmblemHealth Medicare Advantage HMO Plan.


You can enroll in the EmblemHealth Medicare Advantage HMO plan if you:

  • Live in the plan’s Medicare-approved service area, which includes New York City (The Bronx, Brooklyn, Manhattan, Queens and Staten Island), Nassau, Suffolk and Westchester counties
  • Are enrolled in Medicare Part A
  • Are enrolled in Medicare Part B

Enrollment Codes and Rates 2019

What the Plan Costs and Covers

Provider Network 2019

Customer Service


Online Tools to Support Your Health

Health Management and Support Services