EmblemHealth VIP Dual Select (HMO D-SNP)

This plan does not require referrals. This is a special needs plan (D-SNP) for people enrolled in both Medicare and New York State Medicaid. You may pay as little as $0 each month for this plan based on your Low-Income Subsidy (LIS) level. You pay $0 for covered services in this plan.

You will also get benefits Original Medicare does not cover, like comprehensive dental, hearing aids, vision, and a Medicare card for up to $600 in over-the-counter items.

 

Available in the following counties:  Bronx, Kings, Queens, Richmond, New York, Nassau, Orange, Rockland, Suffolk and Westchester

 

Level of extra help Premium
0% $36.60
25% $27.50
50% $18.30
75% $9.20
100% $0.00

Plan Highlights

  • $0 monthly premium plan (based on Low Income Subsidy level)
  • No referrals required
  • $50 Monthly over-the-counter (OTC) card
  • Comprehensive dental services included
  • Healthy Living PATH Program 24 Hour Health Information Line

If you have any questions,
please call
1-800-447-9169 
daily from 8am to 8pm

Benefit Summary

Type of Care Copay
Primary care doctor visit: $0
Specialist doctor visit: $0
Preventive care: $0
Urgently needed services: $0
Emergency room: $0
Inpatient hospital coverage: $0
Lab services: $0
Type of Care Copay
Foot care: $0
Dental services: Comprehensive
Hearing aid: $750 every year
Routine eyewear: $100 every year
SilverSneakers®: Not covered
Prescription drug: Yes

Drug Coverage

Having the medicines you need is an important part of staying healthy, which is why we take our pharmacy offerings very seriously. We strive to help you make sure you can afford the medicines you take. Our formulary gives you access to thousands of them, and our pharmacy network is large enough to provide the choices you need—close to home.

Drug Cost Calculator

Use our Cost Calculator tool to estimate your prescription drug costs. Enter the prescription drugs you take and we'll show you your monthly drug costs.


Medicare HMO and HMO-POS Provider Directories

Health Insurance Plan of Greater New York (HIP) is an HMO/HMO-POS/HMO D-SNP plan with a Medicare contract. HIP has a contract with the New York Medicaid Program for HMO D-SNP. Enrollment in HIP depends on contract renewal. HIP is an EmblemHealth company. This information is not a complete description of benefits. Call 877-344-7364/TTY: 711 for more information.

The SilverSneakers® fitness program is provided by Tivity Health, Inc., an independent company. © 2019. All rights reserved.

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Last Updated: 10/1/19

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