Members 2018 Important Plan Documents

Your important plan documents below include coverage and costs for medical product and services and prescription drugs that will start on January 2018.



2018 Annual Notice of Change


EmblemHealth Medicare VIP Essential (HMO) Download (PDF)
Bronx and Kings
New York and Queens
Richmond and Nassau
Suffolk
Westchester
EmblemHealth Medicare VIP Gold (HMO)
Bronx and Kings
New York and Queens
Richmond and Nassau
Suffolk
Westchester
EmblemHealth Medicare VIP Gold Plus (HMO)
Bronx and Kings
New York, Queens, Richmond and Nassau
Suffolk
Westchester
EmblemHealth Medicare VIP Value (HMO)
EmblemHealth VIP Value (HMO)
EmblemHealth VIP Dual (HMO SNP)
EmblemHealth VIP Dual (HMO SNP)

Nondiscrimination Policy



Evidence of Coverage


Evidence of Coverage Download (PDF)
EmblemHealth VIP Essential (HMO)
EmblemHealth VIP Gold (HMO)
EmblemHealth VIP Gold Plus (HMO)
EmblemHealth VIP Value Plan (HMO)
EmblemHealth VIP Dual (HMO SNP)

Nondiscrimination Policy



Comprehensive and Preventive Dental Benefits


Provider (Health Care Professionals and Facilities) Directory


Monthly Provider Directory Updates

Monthly provider directory updates include recent additions, deletions and changes to the provider network. A group of health care professionals or facilities, such as hospitals, that contract with EmblemHealth for all the counties.

Monthly Provider Directory Updates
Essential Provider Directory Updates
HMO Provider Directory Updates

Full Provider Directories

Essential Provider Directories Download (PDF)
Bronx
Kings
Nassau
New York
Orange and Rockland
Queens
Richmond
Suffolk
Westchester
HMO Provider Directories
Bronx
Kings
Nassau
New York
Orange and Rockland
Queens
Richmond
Suffolk
Westchester


Pharmacy Directory


Pharmacy Directory Download (PDF)
HMO/PPO Pharmacy Directory
National Drug Plan (PDP) Pharmacy Directory


Formulary (list of covered drugs)


Formulary (list of covered drugs) Download (PDF)
2018 EmblemHealth HMO Drug Formulary
Prior Authorization
(means that you will need to get approval from your plan before you fill your certain prescriptions)
Download (PDF)
Step Therapy
(you may need to try a different or more common drug first)
Download (PDF)

Nondiscrimination Policy



Multi-Language Insert


Multi-Language Insert Download (PDF)
HMO
1199 Download (PDF)


Nondiscrimination Policy


Notice of Nondiscrimination Policy

 

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