EmblemHealth recently reached an agreement with the New York State Office of the Attorney General. As part of the settlement, we will reimburse current or former Medicaid managed care, Health and Recovery Plan, Child Health Plus, Essential Plan, Qualified Health Plans, and commercial members (including members in plans offered by City of New York) who may have paid out-of-network cost shares for behavioral health services in excess of their plan’s copayment/coinsurance or deductible between Jan. 1, 2020, and Feb. 19, 2026.
Mental Health
Care for Your Mind
Managing life’s ups and downs can be difficult. Maybe you are going through a divorce, recently had a death in the family, or were recently diagnosed with a chronic or serious illness. Or, perhaps you have been drinking more often lately or want to get help for a loved one with possible substance use issues. No matter the concern, caring for your mental health is just as important as caring for your physical health. We can help.
Important information for current members:
If you submitted a claim with an address other than what EmblemHealth has on file, claim checks will be mailed to the address we have on file for you.
If you need to update your address with us, please follow up with one of the following:
If you enrolled directly through an EmblemHealth representative (not through the NY State of Health marketplace), please call the Customer Service number on your member ID card for information about updating your address.
The submission deadline for Network Claims was Sept. 8, 2026, at 5 p.m. EST. Network claim forms will be considered for payment if they were submitted by or postmarked on this date. No further submissions will be accepted. For updates on when the Directory Claim Filing window will open, please visit emblemhealthrestitution.com.
If you have questions about your claim, call the claims administrator at 978-591-6022 (TTY: 711) from 9 a.m. to 5 p.m., Monday through Friday, or email support@emblemhealthrestitution.com.