EmblemHealth serves our members across all health plans, as well as the communities where our members live, with innovative, evidence-based programs that promote healthy living and advance better health outcomes.
Care for the Family Caregiver provides information, resources and support to promote awareness and understanding of the key role of the family caregiver within the health care system. Through its programs for members and employees, community outreach and partnerships, Care for the Family Caregiver provides support and encouragement to family caregivers to keep them from becoming care recipients. Programs such as Seniorlink are of particular interest to family caregivers with long distance caregiving needs. Seniorlink's national network provides expert assistance in developing senior care planning, regardless of where the care recipient lives, and helps reduce the stress of navigating a complex eldercare system. EmblemHealth continues to host and sponsor the NYC Family Caregiver Coalition. More information, resources and support may be found in the Care for the Family Caregiver webpage: https://www.emblemhealth.com/en/Health-and-Wellness/Live-Better/Care-for-the-Family-Caregiver.aspx.
CME Events and Other Educational Opportunities
Educational opportunities in the arenas of mind and body medicine, self-care and spirituality and belief are available to the EmblemHealth provider community.
Currently, we support this commitment with our continuing medical education (CME) event: the Carl E. Flemister Symposium on Mind/Body Medicine, Spirituality and Health. This symposium makes available to our practitioners the most recent scientific research on the biology and physiology of belief and helps them to consider ways to make this research relevant in their practices. Leading experts on spirituality and health are invited to speak at the symposium.
We have also published a first-of-its-kind training and resource manual called The Medical Manual for Religio-Cultural Competency: A Comprehensive Resource for Providing Quality Care in a Diverse Health Care Setting, written by the Tanenbaum Center for Interreligious Understanding. Practitioners can now look to one resource to provide practical information on how the beliefs and practices of 10 of the world's major religious traditions intersect with medical science. This manual is packed with readily-accessible information for the busy health care practitioner who wants to be religio-culturally competent. Its wide-ranging chapters include practical information on different religions, spiritual assessment forms and tools, and tips for working effectively with people of diverse religious backgrounds and points of view. You may access The Medical Manual in its entirety by signing in to emblemhealth.com.
Glossary terms found on this page:
Acronym for Medicare Advantage. An alternative to the traditional Medicare program in which private plans run by health insurance companies provide health care benefits that eligible beneficiaries would otherwise receive directly from the Medicare program.
An individual and each of his or her eligible dependents, including Medicare beneficiaries who are enrolled or participate in a benefit program and who are entitled to receive covered services from the practitioner pursuant to such benefit program and the terms of the practitioner's agreement.
The group of physicians, hospital, and other medical care providers that a specific plan has contracted with to deliver medical services to its members.
A type of health benefit plan that allows enrollees to go outside the health plan's provider network for care, but requires enrollees to pay higher out-of-pocket fees when they do. Also called Point of Service.
A health plan that offers benefits in-network and out-of-network. In-network services are available to enrollees at lower out-of-pocket cost than the services of non-network providers. In addition, PPO enrollees may self-refer to any network provider at any time. Also called a Preferred Provider Organization.
A medical practitioner or covered facility recognized by EmblemHealth for reimbursement purposes. A provider may be any of the following, subject to the conditions listed in this paragraph:
- Doctor of medicine
- Doctor of osteopathy
- Doctor of podiatric medicine
- Physical therapist
- Nurse midwife
- Certified and registered psychologist
- Certified and qualified social worker
- Nurse anesthetist
- Speech-language pathologist
- Clinical laboratory
- Screening center
- General hospital
- Any other type of practitioner or facility specifically listed in the member's Certificate of Insurance as a practitioner or facility recognized by EmblemHealth for reimbursement purposes
A provider must be licensed or certified to render the covered service. The covered service must be within the scope of the Provider's license or certification.