EmblemHealth VIP Rx Plus (PDP)

With VIP Rx Plus, you get $0 preferred generic drugs at preferred pharmacies nation-wide and only $20 for a 90-day supply of Tier 2 generic drugs when you use our mail order pharmacy. The deductible does not apply to drugs on Tiers 1, 2 and 3, so you save on the medicines you need.

 

Your level of extra help Premium
0% $68.20
25% $59.10
50% $49.90
75% $40.80
100% $31.60

If you have any questions,
please call 
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-$3,800

You Pay
Coverage Gap Over $3,800

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 $8 25% of the cost
$3.60 or 5% of the cost
Tier 3 Preferred Brand Drugs No Deductible $40 25% of the cost
$8.95 or 5% of the cost
Tier 4 Non-Preferred Drugs $275 $95 25% of the cost
$3.60, $8.95 or 5% of the cost
Tier 5 Specialty Drugs $275 28% 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. This information is not a complete description of benefits. Call 877-344-7364/TTY: 711 for more information.

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Last Updated: 10/1/19

Y0026_ 127364 Accepted 10/1/19