Our EPO Value Plan offers a large network of doctors and hospitals, and a broad range of in-network-only benefits. It’s an affordable and convenient plan for members and groups.
Members who enroll in EmblemHealth’s EPO Value Plan must choose a Primary Care Physician (PCP).
They do not need a referral from their primary care physician to see in-network specialists.
Members receive services that include medical, hospital, and prescription drug coverage.
- This plan is available for businesses headquartered in New York City, Nassau, Suffolk, and Westchester counties.
- Businesses must have 101 or more employees.
- This plan provides in-network coverage.
- There are no claims to file - our network doctors do it for you.
Helping Members Stay Healthy
In addition to their doctor’s care, below are some programs members can join to help them and their enrolled family members stay healthy.
Wellness PATH Programs* .
- Wellness Program: Support for weight management, stress reduction, physical activity and more.
- Healthy Beginnings Pregnancy Management Program: For the health of mom and baby.
- Tobacco-Free Smoking Cessation Program: Get help quitting.
Discount Health Programs
- Discounts on weight-loss programs, laser vision, acupuncture and more.**
- Quit-smoking programs.
- A Nurse Advice Line that members can call 24/7 to speak with a registered nurse.
- Self-management help tools on our secure member portal at emblemhealth.com.
Take a closer look at the health and wellness programs we offer.
* Availability of health and wellness programs may vary based on the EmblemHealth product selected.
** EmblemHealth cannot ensure that a particular vendor will remain in the program. The services available under these programs are not covered services underwritten by HIP Insurance Company of New York (“HIPIC”) as part of the plan.
Informational Purposes Only
Some services are subject to prior authorization. This summary is provided for information only; it does not contain complete details of the plan and it does not constitute an Agreement.
The EmblemHealth EPO Value program is underwritten by HIP Insurance Company of New York (HIPIC) and provides in-network benefits only. Except for emergency hospital care, no out-of-network services are covered. Coverage is subject to all terms, conditions, limitations, and exclusions set forth in the contract and certificate of insurance. Refer to HIPIC policy form numbers 151-23-LGEPOSCHEDULE (10/16), et. al.