EmblemHealth Bronze

Who's eligible: Individuals and families living within the 28 New York counties. Children and young adults can stay on a parent’s plan until age 26. 

 

Financial assistance: Tax credits available for qualified individuals to help with premiums and out-of-pocket costs when enrolling on the NY State of Health Marketplace.

  • dental
  • vision
  • telemedicine

Benefits Summary

Referralsnfo Required for specialist visits
Deductible info  $4,700 individual/$9,400 family
Out-of-pocket maximuminfo $8,550 individual/$17,100 family
Out-of-networkinfo  coverage  No coverage for non-emergency services
Primary care physicianinfo  3 visits for $50 before deductible, then $50 after deductible
Preventive care info Fully covered
Specialist 3 visits for $75 before deductible, then $75 after deductible
Urgent care  50% coinsurance after deductible
Pharmacy $10 generic drugs after deductible
Telemedicineinfo Fully covered
Gym  Reimbursement up to $400 per calendar year if qualified
Dental Pediatric dental care
Vision Pediatric vision benefits

Provider Network

The Bronze plan is on EmblemHealth’s Select Care Network. Members are responsible for the total cost of non-emergency care they receive outside their plan’s provider network.


Cost Calculator

Since our Individual/Family and Essential 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.

*The letter "D" after a plan name indicates that the plan is available directly from EmblemHealth, rather than through the NY State of Health Marketplace.