EmblemHealth HMO Plus:
An Addition to Tradition!

Date Issued: 1/10/2017

Our new EmblemHealth HMO Plus is a traditional HMO with the addition of an upfront-deductible, which must be satisfied before copayments are applied.

The deductible does not apply to the following:

  • Services provided by a Primary Care Physician (PCP)
  • Preventive services
  • Diabetic equipment, supplies and self-management
  • Maternity services
  • Outpatient mental health/substance abuse care
  • Treatment for Autism Spectrum Disorder

There is a separate deductible for:

  • Prescription Drugs
    — Pharmacy may or may not be subject to a separate deductible
  • Equipment and Devices
    — The equipment and devices deductible is combined for durable medical equipment and braces, prosthetics and shoe inserts

Click here for complete HMO Plus Benefit Summaries.

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