You’ve looked at your options, and now you’re ready to enroll in a New York Medicare plan. We want to make the process as easy as possible for you. This section outlines your four EmblemHealth Medicare Advantage Prescription Drug plans and Medicare Prescription Drug standalone plan enrollment options. Members may enroll in the change to a plan only during specific times of the year.

Below are your four EmblemHealth Medicare Advantage Plan enrollment options.


If you’ve already selected a plan, you can enroll with us online by clicking the enroll online button below. You can also enroll in an EmblemHealth Medicare Advantage Plan through the Centers for Medicare & Medicaid Services Online Enrollment Center at


Make a Face to Face Appointment
You can schedule an appointment with a New York-based EmblemHealth Sales Representative who will answer your questions and help you complete the enrollment application.

Attend a seminar

Explore your options during the Annual Election Period (AEP) with a virtual seminar, led by a Medicare expert.

We also have in-person seminars at select locations where we can arrange a safe experience. 

Find an in-person seminar near you.

Call us at 800-859-4880 (TTY:711), 8 am to 8 pm, seven days a week to make an appointment or if you have questions about a seminar in your area.

By Phone

Medicare beneficiaries may enroll in an EmblemHealth Medicare Advantage Plan over the phone by calling us toll-free at 800-859-4880, (TTY: 711) seven days a week, 8 am to 8 pm.

By Mail

You can download a Medicare Advantage,  enrollment form below for the plan you want to enroll in, complete it and send it to us. We will confirm we received your form by mail.


2021 EmblemHealth Medicare Advantage (HMO) Enrollment Form for all VIP Plans except EmblemHealth VIP Dual plans and Capital Region

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2021 EmblemHealth Medicare (HMO) Advantage Enrollment Form for all Capital Region plans (Albany, Broome, Columbia, Delaware, Greene, Rensselaer, Saratoga, Schenectady, Warren and, Washington)

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2021 Optional Supplemental Benefit Form (dental and fitness) for members of VIP Part B Saver and VIP Value plans.

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2021 EmblemHealth Medicare Advantage Enrollment form for EmblemHealth VIP Dual (HMO D-SNP), EmblemHealth VIP Dual Select (HMO D-SNP) and EmblemHealth VIP Solutions (HMO D-SNP) and VIP Dual Reserve (HMO D-SNP)

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2021 EmblemHealth Prescription Drug Plan (PDP) Enrollment Form for VIP Rx (PDP) and EmblemHealth VIP Rx Plus (PDP) Medicare 2020 EmblemHealth VIP Rx (PDP) and EmblemHealth VIP Rx Plus (PDP) Medicare Application

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Mail your enrollment form to:

EmblemHealth Medicare
P.O. Box 4001
Farmington, Connecticut 06034-9900

To join an EmblemHealth Medicare plan, you must:

  • Qualify and be enrolled in Medicare Part A (you are 65 or older, or under 65 with certain disabilities); and
  • Be enrolled in and continue to pay for Medicare Part B; and
  • Live in EmblemHealth’s service area for that plan; and
  • Not have End-Stage Renal Disease (permanent kidney disease requiring dialysis or a kidney transplant), except under certain limited circumstances.


View EmblemHealth's HMO  Service Area map which include the following counties in New York: Albany, Broome, Bronx, Columbia, Delaware, Dutchess, Greene, Kings, Nassau, New York, Orange, Putnam, Queens, Rensselaer, Richmond, Rockland, Saratoga, Schenectady, Suffolk, Sullivan, Warren, Washington, Westchester and Ulster


EmblemHealth HMO Medicare Service Area Map

Download PDF:  English |  Español  |  中文


Initial Coverage Election Period

You can enroll when you first become eligible for Medicare (three months before the month you turn age 65 until three months after the month you turn age 65). If you get Medicare due to a disability, you can join from three months before to three months after your 25th month of cash disability payments.

Medicare beneficiaries may enroll only during specific times of the year. Visit our Medicare Enrollment Periods page to see the best time to enroll and other details about enrollment timelines.

What happens after I enroll?

We will mail you a letter confirming that we received your application. After that, we will send your application to the Centers for Medicare and Medicaid Services (CMS), the federal agency that runs the Medicare program, for approval.


When am I officially an EmblemHealth member?

You should get your EmblemHealth member ID card and Welcome Kit in the mail about seven business days after you receive our confirmation letter. An EmblemHealth Customer Service Representative will also call you to answer your questions and help you understand your benefits.


During one of these calls, you will be asked some questions about your health. This is because CMS asks all Medicare Advantage plans to do a Health Risk Assessment (HRA) for members. It will not affect your membership in EmblemHealth in any way. And your answers may help EmblemHealth to serve you better.

Last Updated 01/01/2021

Y0026_ 200570  Accepted 9/29/20