EmblemHealth Medicare Supplement Insurance Plans

  • EmblemHealth offers a variety of Supplement Plans if you choose not to select a Medicare Advantage plan.

    If you like the idea of having a plan that gives you the freedom to choose any doctor and hospital that accepts Medicare and lessens your exposure to out-of-pocket expenses, a Medicare Supplement Plan might be right for you. These plans do exactly what their name says: they supplement Original Medicare — or in other words, make the coverage provided by Original Medicare more complete.

    Monthly Premium Rates

    Each rating region consists of the noted counties. Rates and benefits are subject to change. Please refer to your contract or contact EmblemHealth for additional information, including limitations and exclusions.

    Region Plan A Plan B Plan C Plan F

    Albany
    Albany, Clinton, Columbia, Essex, Fulton, Greene, Montgomery, Rensselaer, Saratoga, Schenectady, Schoharie, Warren and Washington

    $161.29

    $216.47

    $288.56

    $317.87

    Buffalo
    Allegany, Cattaraugus, Chautauqua, Erie, Genesee, Niagara, Orleans and Wyoming

    $152.57

    $204.82

    $272.95

    $300.67

    Downstate
    Bronx, Kings, Nassau, New York, Queens, Richmond, Rockland, Suffolk and Westchester

    $169.45

    $226.14

    $300.87

    $331.43

    Mid-Hudson
    Delaware, Dutchess, Orange, Putnam, Sullivan and Ulster

    $161.29

    $216.47

    $288.56

    $317.87

    Rochester
    Livingston, Monroe, Ontario, Seneca, Wayne and Yates

    $152.57

    $204.82

    $272.95

    $300.67

    Syracuse
    Broome, Cayuga, Chemung, Cortland, Onondaga, Schuyler, Steuben, Tioga and Tompkins

    $157.73

    $211.71

    $282.08

    $310.74

    Utica/Watertown
    Chenango, Franklin, Hamilton, Herkimer, Jefferson, Lewis, Madison, Oneida, Oswego, Otsego and St. Lawrence

    $152.57

    $204.82

    $272.95

    $300.67

    When Coverage Begins

    Coverage begins on the effective date of the contract as shown on the contract schedule page, which is sent to you upon receipt of your initial payment. For open enrollment applications approved between the first and 15th of the month, coverage will begin on the first day of the following calendar month. For open enrollment applications approved after the 15th of the month, coverage will begin on the first day of the second month after approval. A waiting period of six months is required for pre-existing conditions. The waiting period applies to conditions for which medical advice or medical treatment was recommended by or received from a physician within six months of your effective date of coverage. However, the six-month waiting period may be reduced if you are replacing an existing plan. Your EmblemHealth Medicare Supplement contract will describe the circumstances under which your EmblemHealth Medicare Supplement plan’s waiting period may be reduced by the period of time you have been covered under your existing plan.

    Helpful Resource

    2017 Medicare Supplement Brochure —Helpful information for beneficiaries.

  • Basic Benefits

    All four supplemental plans offered by EmblemHealth cover the following basic benefits:

    • Hospitalization: EmblemHealth pays Part A coinsurance* plus coverage for 365 additional days in your lifetime after Medicare benefits end
    • Medical Expenses: EmblemHealth pays Part B coinsurance* (generally 20 percent of Medicare-approved expenses)
    • Blood: First three pints of blood each year
    • Hospice Part A coinsurance
    • Plan A - Plan A consists of Basic Benefits only, as described above
    • Plan B - In addition to the Basic Benefits, Plan B covers 2017 Part A inpatient deductible** per benefit period: $1,316
    • Plan C - In addition to the Basic Benefits, Plan C covers coinsurance* for skilled nursing facility care
    • 2017 Part A inpatient deductible** per benefit period: $1,316
    • 2017 Part B annual deductible: $183
    • Emergency care rendered during the first 60 days of foreign travel
    • Plan F - In addition to the Basic Benefits, Plan F covers coinsurance* for skilled nursing facility care
    • 2017 Part A inpatient deductible** per benefit period: $1,316
    • 2017 Part B annual deductible: $183
    • Emergency care rendered during the first 60 days of foreign travel
    • 100% of Part B excess charges (above Medicare-approved amounts)

    * Coinsurance is the portion or percentage of the cost of a Medicare covered service that you are responsible for paying.

    ** Part A inpatient deductible is the dollar amount of costs for covered services you would be expected to pay for Medicare Part A hospitalization services, including semi-private room and board, and general nursing and miscellaneous services and supplies during the first 60 days of a covered admission.

  • Eligibilty

    Medicare Supplement Insurance is available throughout the year on a continuous, open-enrollment basis. To apply for coverage under one of EmblemHealth’s Medicare Supplement Insurance Plans, you must:

    • Be eligible for Medicare
    • Reside in New York State
    • Not have coverage provided by Medicaid
    • Not have coverage by any other health insurance plan providing duplicate coverage

    If you have coverage through EmblemHealth or another health insurance plan, you may apply for an EmblemHealth Medicare Supplement Insurance Plan if your current coverage is ending and you intend to replace your existing coverage. This way you will have no break in coverage.

    Enroll

    To apply for an EmblemHealth Medicare Supplement plan, simply complete and return the application below to us. Do not send any payment with your application. Once the application is processed, you will receive an invoice along with a copy of your application and a contract for your review. You will have 30 days to review the contract. If you are not satisfied with it, simply return it to us. Upon receipt of your initial payment, identification cards will be sent to you.

    EmblemHealth Medicare Supplement Enrollment Form


    Mail the form to:


    EmblemHealth
    Attention: Medicare Marketing
    PO Box 2859
    New York, NY 10117-7894