Skip to main content

Find a Doctor

Find a Doctor

Sign In

Sign In

$0 Premium Essential Plan

Help Renewing Your Plan

HIP HMO Preferred Gold Plan
Contact us

Individual and Family Plans
Serviced by the Millennium Network

young happy family walking outside

Plan Benefits

Our qualified health plans offer a range of benefits to help you stay healthy with access to top doctors in our Millennium Network. You must stay in-network to receive coverage.

  • Preventive Care

    No-cost annual checkups, routine screenings, immunizations, and more.

  • Prescription Drugs

    Coverage for the medicines your doctor prescribes.

  • Telemedicine

    Convenient nonemergency care through Teladoc®.

  • Dental

    Pediatric dental coverage through DentaQuest for children up to age 19.

Compare Plans

We offer a range of plans through New York’s health insurance marketplace as well as other coverage options for individuals and families.

Financial assistance: You may be eligible for tax credits to help with premiums and out-of-pocket costs when enrolling through NY State of Health (NYSOH).

Bronze

Silver

Gold

Platinum

A smart choice if you want to pay less for premiums and don’t seek frequent medical care.

Monthly Premium:

In-Network Deductible:
High

See Details Hide Details

A good balance if you go to the doctor regularly but want a low premium.

Monthly Premium:

In-Network Deductible:
Moderate

See Details Hide Details

Consider this if you go to the doctor often and want a low deductible.

Monthly Premium:

In-Network Deductible:
Low

See Details Hide Details

An option if you receive frequent care and don’t want a deductible.

Monthly Premium:

In-Network Deductible:
Lowest

See Details Hide Details

Highlight Differences
Monthly Premium
LowestLowModerateHigh
Deductible
$4,125 individual/$8,250 family$2,450 individual/$4,900 family$775 individual/$1,550 family$0 individual/$0 family
Maximum Out-of-Pocket
$10,150 individual/$20,300 family$10,150 individual/$20,300 family$10,150 individual/$20,300 family$2,000 individual/$4,000 family
Summary of Benefits and Coverage
Marketplace Plans*
Off-Exchange Plans Marketplace Plans*
Off-Exchange Plans Marketplace Plans*
Off-Exchange Plans Marketplace Plans*
Off-Exchange Plans
Network
9 counties9 counties9 counties9 counties
Referrals
Required for specialist visitsRequired for specialist visitsRequired for specialist visitsRequired for specialist visits
Out-of-Network Coverage
No coverage for nonemergency servicesNo coverage for nonemergency servicesNo coverage for nonemergency servicesNo coverage for nonemergency services
Preventive Care
Covered in full**Covered in full**Covered in full**Covered in full**
Primary Care Provider (PCP) Visits
$50 copay after deductible with up to three copay visits*** before deductible$30 copay after deductible with one copay visit*** before deductible$25 copay after deductible$15 copay
Specialist Visits
$75 copay after deductible with up to three copay visits*** before deductible$65 copay after deductible with one copay visit*** before deductible$40 copay after deductible$35 copay
Telemedicine
Covered in fullCovered in fullCovered in fullCovered in full
Urgent Care
$75 copay after deductible$70 copay after deductible$60 copay after deductible$55 copay
Emergency Room
$500 copay after deductible$500 copay after deductible$150 copay after deductible$100 copay
Pharmacy
$10 copay for generic drugs after deductible$15 copay for generic drugs before deductible$10 copay for generic drugs before deductible$10 copay for generic drugs
Gym Reimbursement
Reimbursement up to $400 per calendar year if qualifiedReimbursement up to $400 per calendar year if qualifiedReimbursement up to $400 per calendar year if qualifiedReimbursement up to $400 per calendar year if qualified
Pediatric Dental and Vision
Coverage up to age 19Coverage up to age 19Coverage up to age 19Coverage up to age 19
Health Savings Account (H.S.A) Compatible
YesNoNoNo

*Plans through NY State of Health (NYSOH).

**Preventive services are not subject to cost-sharing (copayments, deductibles, or coinsurance) when performed by a network provider and provided in accordance with the comprehensive guidelines supported by the Health Resources and Services Administration (HRSA), or if the items or services have an “A” or “B” rating from the U.S. Preventive Services Task Force (USPSTF), or if the immunizations are recommended by the Advisory Committee on Immunization Practices (ACIP), or when required by state law.

***Predeductible visit(s) apply to any combination of PCP, specialist, allergy testing and treatment, chiropractic services, second opinions, applied behavioral analysis (ABA) treatment, or outpatient mental health/substance use disorder.

Compare Plans

We offer a range of plans through New York’s health insurance marketplace as well as other coverage options for individuals and families.

Financial assistance: You may be eligible for tax credits to help with premiums and out-of-pocket costs when enrolling through NY State of Health (NYSOH).

Bronze

Silver

Gold

Platinum

Catastrophic

A smart choice if you want to pay less for premiums and don’t seek frequent medical care.

Monthly Premium:

In-Network Deductible:
High

See Details Hide Details

A good balance if you go to the doctor regularly but want a low premium.

Monthly Premium:

In-Network Deductible:
Moderate

See Details Hide Details

Consider this if you go to the doctor often and want a low deductible.

Monthly Premium:

In-Network Deductible:
Low

See Details Hide Details

An option if you receive frequent care and don’t want a deductible.

Monthly Premium:

In-Network Deductible:
Lowest

See Details Hide Details

For individuals under age 30 and those who qualify for financial assistance.

Monthly Premium:

In-Network Deductible:
Highest

See Details Hide Details

Highlight Differences
Monthly Premium
LowestLowModerateHighLowest for those meeting eligibility requirements
Deductible
$3,800 individual/$7,600 family$2,100 individual/$4,200 family$600 individual/$1,200 family$0 individual/$0 family$9,200 individual/$18,400 family
Maximum Out-of-Pocket
$9,200 individual/$18,400 family$9,200 individual/$18,400 family$7,900 individual/$15,800 family$2,000 individual/$4,000 family$9,200 individual/$18,400 family
Summary of Benefits and Coverage
Marketplace Plans*
Off-Exchange Plans Marketplace Plans*
Off-Exchange Plans Marketplace Plans*
Off-Exchange Plans Marketplace Plans*
Off-Exchange Plans Marketplace Plans*
Off-Exchange Plans
Network
9 counties9 counties9 counties9 counties9 counties
Referrals
Required for specialist visitsRequired for specialist visitsRequired for specialist visitsRequired for specialist visitsRequired for specialist visits
Out-of-Network Coverage
No coverage for nonemergency servicesNo coverage for nonemergency servicesNo coverage for nonemergency servicesNo coverage for nonemergency servicesNo coverage for nonemergency services
Preventive Care
Covered in full**Covered in full**Covered in full**Covered in full**Covered in full**
Primary Care Provider (PCP) Visits
$50 copay after deductible with up to three copay visits*** before deductible$30 copay after deductible with one copay visit*** before deductible$25 copay after deductible$15 copayThree no-cost PCP visits, then 0% coinsurance after deductible
Specialist Visits
$75 copay after deductible with up to three copay visits*** before deductible$65 copay after deductible with one copay visit*** before deductible$40 copay after deductible$35 copay0% coinsurance after deductible
Telemedicine
Covered in fullCovered in fullCovered in fullCovered in full0% coinsurance after deductible
Urgent Care
$75 copay after deductible$70 copay after deductible$60 copay after deductible$55 copay0% coinsurance after deductible
Emergency Room
$500 copay after deductible$500 copay after deductible$150 copay after deductible$100 copay0% coinsurance after deductible
Pharmacy
$10 copay for generic drugs after deductible$15 copay for generic drugs before deductible$10 copay for generic drugs before deductible$10 copay for generic drugs0% coinsurance after deductible
Gym Reimbursement
Reimbursement up to $400 per calendar year if qualifiedReimbursement up to $400 per calendar year if qualifiedReimbursement up to $400 per calendar year if qualifiedReimbursement up to $400 per calendar year if qualifiedReimbursement up to $400 per calendar year if qualified
Pediatric Dental and Vision
Coverage up to age 19Coverage up to age 19Coverage up to age 19Coverage up to age 19Coverage up to age 19

*Plans through NY State of Health (NYSOH).

**Preventive services are not subject to cost-sharing (copayments, deductibles, or coinsurance) when performed by a network provider and provided in accordance with the comprehensive guidelines supported by the Health Resources and Services Administration (HRSA), or if the items or services have an “A” or “B” rating from the U.S. Preventive Services Task Force (USPSTF), or if the immunizations are recommended by the Advisory Committee on Immunization Practices (ACIP), or when required by state law.

***Predeductible visit(s) apply to any combination of PCP, specialist, allergy testing and treatment, chiropractic services, second opinions, applied behavioral analysis (ABA) treatment, or outpatient mental health/substance use disorder.

Convenient Care Where You Live and Work

To enroll in an EmblemHealth plan serviced by the Millennium Network, you must live in the eligible service area:

The five boroughs of New York City, Long Island, and Westchester and Rockland counties. Depending on income and other factors, you may also be eligible for a $0 premium Essential Plan or Medicaid coverage options.

We offer individual and family plans serviced by the Select Care Network if you live in the service area indicated on the map.

Helpful Resources

Our plans offer access to top health care professionals and conveniently located pharmacies.

The EmblemHealth Difference

Your health and well-being depends on more than just going to the doctor. That’s why we offer you additional wellness benefits to help keep you feeling your best.

group five woman laughing and smiling before a yoga class

Neighborhood Care

Visit us for help with your plan or take a free† wellness class.
woman is in the kitchen watching a virtual health related video

Vitality WellSpark

Join group health coaching, watch helpful videos, and more.
group fitness class

Gym Reimbursement

Get $200 every six months, up to $400 per year.
man trying on eye glasses at the store

Vision Discounts

Save on glasses, contact lenses, eye exams, and more.

†Free, with no obligation to enroll.

Frequently Asked Questions

Get the answers you need to make the most of your plan.

When and how do I enroll in or renew my coverage?

You can enroll in an EmblemHealth individual and family plan during open enrollment. This yearly period begins in November for coverage starting Jan. 1 of the next calendar year. NY State of Health (NYSOH) determines when the open enrollment period starts and ends in New York state.

Outside of open enrollment, you may still be able to enroll in coverage if you have certain qualifying life events, like getting married, having a baby, losing other health coverage, or experiencing a change in your household income.

In advance of open enrollment each year, EmblemHealth and NYSOH will mail renewal notices to plan members with information on when to renew and what documentation needs to be provided (for example, pay stubs, tax returns, or other proof of income). Information about financial help and monthly premiums will also be included.

I can’t afford coverage. What options do I have?

There is help available to pay for coverage through NYSOH. Once you submit your application for coverage, NYSOH will determine what assistance you may be eligible for based on the information you’ve provided. Financial help is available in two ways: advance premium tax credits (APTC) and cost-sharing reductions (CSR).

If you qualify for an APTC, your monthly premium will be lower. If you qualify for a CSR, your premium and cost-sharing for care will be reduced. To qualify for either form of assistance, you must apply for and enroll in coverage through NYSOH.

I’m pregnant. Are there any changes to my plan due to my pregnancy?

Beginning Jan. 1, 2025, pregnant and postpartum* members enrolled in an individual and family plan** through NYSOH will have cost-sharing waived for most services. Cost-sharing waivers are contingent on federal funding and may change or end during the plan year.

Cost-sharing will still apply for the following services:

  • Inpatient hospital and birthing center services for delivery.
  • All inpatient services (e.g., hospital, rehabilitation, mental health/substance use disorder, and hospice). 
  • Emergency care in a hospital. 
  • Physician, nurse practitioner, and midwife services for delivery.
  • Ambulance services. 
  • Pediatric vision and dental services.

*The postpartum period lasts 12 months following any pregnancy.
** Excluding those enrolled in a Catastrophic plan.

I have diabetes. Are there changes to my coverage?

Yes, as of Jan. 1, 2025, prescription insulin is covered with a $0 cost-share for members enrolled in individual and family plans. Copays, coinsurance, and deductibles will also be waived for members with a diabetes diagnosis who are enrolled in an individual and family plan*** through NYSOH, for the following:

  • Primary care office visits for the diagnosis, management, and treatment of diabetes. 
  • One office visit to perform an annual dilated retinal examination. 
  • One office visit to perform an annual diabetic foot exam. 
  • Diabetic self-management education services. 
  • Laboratory procedures and tests for the diagnosis and management of diabetes. 
  • Diabetic equipment and related supplies for the treatment of diabetes when prescribed by your doctor or another professional who is legally authorized to prescribe, including:
    • Acetone reagent strips. 
    • Acetone reagent tablets. 
    • Alcohol or peroxide by the pint. 
    • Alcohol wipes. 
    • All insulin preparations. 
    • Automatic blood lance kit. 
    • Cartridges for the visually impaired. 
    • Diabetes data management systems. 
    • Disposable insulin and pen cartridges. 
    • Drawing-up devices for the visually impaired. 
    • Equipment for use of the insulin pump, including batteries.
    • Glucagon for injection to increase blood glucose concentration.
    • Glucose acetone reagent strips. 
    • Glucose kit. 
    • Glucose monitor (with or without special features for visually impaired), control solutions, and strips for home glucose monitor. 
    • Glucose reagent tape.
    • Glucose test or reagent strips. 
    • Injection aides.
    • Injector (Busher) automatic.
    • Insulin cartridge delivery. 
    • Insulin infusion devices.
    • Insulin pump. 
    • Lancets. 
    • Oral agents such as glucose tablets and gels. 
    • Oral antidiabetic agents used to reduce blood sugar levels.
    • Syringe with needle; sterile 1 cc box. 
    • Urine testing products for glucose and ketones. 
    • Additional supplies, as the New York State Commissioner of Health shall designate by regulation as appropriate for the treatment of diabetes.        

Note: Cost-sharing may apply to other services provided during the same visit as diabetic services.
*** Excluding members enrolled in a Catastrophic plan.

Additional Enrollment Resources

WE’RE HERE FOR YOU

Need help finding the right plan?

Call us at 866-230-1071 (TTY: 711), 9 a.m. to 6 p.m., Monday through Friday.

Or request a call.

telemarketer with headphones at computer

Ready to enroll?

We use cookies on this website to give you the best experience and to measure website usage. By continuing to use this website, you consent to these cookies. View our Privacy Policy here.
Also of Interest: 
Individual & Family Plans   |   Health Insurance in New York   |   State-Sponsored Programs