EmblemHealth VIP Rx (PDP)

With VIP Rx, you get $0 preferred generic drugs at preferred pharmacies nation-wide. You pay small a premium of $41 per month.

 

Your level of extra help Premium
0% $41.00
25% $31.90
50% $22.70
75% $13.60
100% $4.40

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

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.

 

     Deductible (The amount you pay before your plan starts to pay)

You Pay
Initial Coverage $0-$4,020

You Pay
Coverage Gap Over $4,020

You Pay
Catastrophic Over $6,350

You Pay
Tier 1 Preferred Generic Drugs No Deductible $0 25% of the cost $3.60 or 5% of the cost
Tier 2 Generic Drugs No Deductible $15 25% of the cost
$3.60 or 5% of the cost
Tier 3 Preferred Brand Drugs $435 $45 25% of the cost
$8.95 or 5% of the cost
Tier 4 Non-Preferred Drugs $435 35% of the cost
25% of the cost
$3.60, $8.95 or 5% of the cost
Tier 5 Specialty Drugs $435 25% of the cost 25% of the cost
$3.60, $8.95 or 5% of the cost

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. For more information, contact the plan. This information is not a complete description of benefits. Call 877-344-7364 TTY: 711 for more information. For more information, contact the plan. This information is not a complete description of benefits. Call 877-444-7241 (TTY: 711) for more information.

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Last Updated: 10/1/19

Y0026_ 127364 Accepted 10/1/19