EmblemHealth VIP Solutions (HMO D-SNP)

This is a special needs plan (D-SNP) for people enrolled in both Medicare and who have partial or full 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 may pay $0 or low copays depending on your level of Medicaid for covered services in this plan.

You will also get benefits Medicare does not cover, like preventive dental, $0 for 10 additional acupuncture visits, hearing aids, and vision.


Available in the following counties: Albany, Bronx, Broome, Columbia, Delaware, Dutchess, Greene, Kings, Queens, Richmond, New York, Nassau, Orange, Putnam, Ulster, Rensselaer, Rockland, Saratoga, Schenectady, Suffolk, Sullivan, Warren, Washington, and Westchester


Provider Network: VIP Bold


Your level of Extra Help Premium
0% $42.30
25% $31.70
50% $21.20
75% $10.60
100% $0.00

Plan Highlights

If you have questions, please call: 800-859-4880 daily from
8 am to 8 pm.

Benefit Summary

Type of Care Copay
Primary care doctor visit: $0
Specialist doctor visit: $0 or $25
Preventive care (Services that keep you healthy): $0
Urgently needed services: $0 or $30
Emergency room: $0 or $90
Inpatient hospital coverage: $0 or $310 per day 1-6, $0 additional days
Type of Care Copay
Lab services: $0 or $15
X-rays: $0 or 20% of the cost
Foot care: $0 or $40
Dental services: Preventive
Hearing Aids: $350 every year
Routine eyewear: $200 every year
24-Hour nurse hotline: Yes
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.


Plan Documents

Medicare HMO and HMO-POS Provider & Pharmacy Directories

EmblemHealth Plan Inc. is an HMO/HMO-POS/HMO D-SNP plan with a Medicare contract and a Coordination of Benefits Agreement with the New York State Department of Health. Enrollment in EmblemHealth depends on contract renewal. EmblemHealth Plan Inc. is an EmblemHealth company.

SilverSneakers® is a registered trademark of Tivity Health, Inc. © 2020 Tivity Health, Inc. All rights reserved.


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Last Update 10/01/2020

Y0026_ 200570  Accepted 9/29/20