Platinum Premier M

This plan is on our narrow Millennium network and has a $0 deductible. It is a good option if you receive frequent care.

Which groups are eligible: Small businesses with 1 to 100 full-time equivalent (FTE) employees and a primary business address in New York State.

Which employees are eligible:
Qualifying individuals and families living in one of the 5 NYC boroughs, Long Island, or Westchester coutny. including the five NYC boroughs, Westchester county. Children and young adults can stay on a parent’s plan until age 26, or through age 29 for an added cost.

 

  • dental
  • vision
  • Generic Drugs
  • telemedicine

Contact EmblemHealth Sales at: 1-877-347-0440

Benefits Summary

Referrals info Referrals are required for specialist visits.
Deductible info $0 Individual/$0 Family
Out-of-Pocket maximum info $2,000 Individual/$4,000 Family
Out-of-Network info coverage for non-emergency No.
Primary care doctor info Three free sick-visits then 0% after deductible.  
Preventive care info Covered in full (includes annual physical, immunizations, and more).
Specialist info $35
Urgent Care $75 
Pharmacy Free generic drugs.
Telemedicine info Covered in full.
Gym reimbursement Up to $400 per plan year if qualified.
Dental Pediatric dental care
Vision Pediatric vision benefits

Cost Calculator

Since our Small Group Plans offer network-only coverage, members are responsible for the total cost of non-emergency care they receive outside their plan’s provider network.

 

Use the FAIR Health Calculator* to estimate the cost of non-emergency medical services and procedures by zip code.

 

*FAIR Health, Inc. is an independent nonprofit organization that uses actual provider charges when calculating fees. FAIR Health ensures that its fee information is accurate and complete. Please review the privacy policy and terms and conditions posted on the FAIR Health website.

See what providers are in-network

With our robust network of quality doctors, you can get care from many of the region’s leading doctors, clinicians and facilities, including hospitals and urgent care centers.


EmblemHealth Platinum Premier is underwritten by HIP Health Plan of New York. Coverage is subject to all terms, conditions, limitations and exclusions set forth in the contract. Refer to HIP policy form number 155-23-SGOFFHIXCONTRACT (04/17).

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