Welcome!

We’re committed to supporting you. An important part of that commitment is making sure you’re informed about all the resources available to you. Here, we’ve put together details on tools that can help you receive the best quality of care.


Member Resources Available on Our Website

Questions about your coverage? You can find answers online at emblemhealth.com. Helpful information on our website includes:

  • Benefits and services included in, and excluded from, coverage.
  • Procedures to follow for prescription drug coverage, as well as your plan’s pharmacy restrictions and preferences.
  • Copays and other fees you may need to pay.
  • Printing a temporary ID card and requesting a replacement permanent card.
  • The most up-to-date list of network doctors and other practitioners.
  • How to change your primary doctor.
  • Submitting claims for covered services.
  • Benefit restrictions that apply to services obtained outside of the organization’s system or service area.
  • How to get care outside of normal business hours.
  • How to get primary care, specialty care, hospital services, mental health care, and substance use services.
  • How to get care when you’re out of your plan’s service area.
  • How to voice a complaint or file an appeal.
  • How to get help in another language.
  • Emergency care and when to call 911.
  • How we evaluate new medical technology for covered benefits.
  • Creating a personal health record.
  • Taking a health risk assessment.
  • Health and wellness information.

To learn more about your plan’s pharmacy restrictions and preferences, please log in to emblemhealth.com. Pertinent pharmacy information can be found in both your member handbook and the pharmacy web page.