2018 Benefit Changes to Government Programs

Date Issued: 3/15/2018

We're pleased to announce these expanded benefits and services for our members. Please share these messages with your EmblemHealth patients.

Child Health Plus – On September 18, 2017, we began covering Child Health Plus members for products included on the Medicaid over-the-counter drug list. For example, Children’s Motrin® and Children’s Tylenol® are now covered for Child Health Plus members. See our Policy Alert.

Medicare – Members who have Medicare and Medicaid (VIP DUAL [HMO SNP]) coverage can now take advantage of these benefits:
  • PCP and physical therapy services at $0 cost-share (providers receive 100% reimbursement directly from the Plan/Managing Entity).
  • Fitness benefit at $0 cost
  • Increase in monthly over-the-counter drug benefit (from $60 to $100)
  • Transportation coverage at $0 cost (24 one-way trips/12 roundtrips).

Login to the secure provider website to see details in the member’s Benefit Summary.