2022 EmblemHealth VIP Dual Select (HMO D-SNP) | EmblemHealth

Switch to:

EmblemHealth VIP Dual Select (HMO D-SNP)

This is a special needs plan (HMO D-SNP) for people enrolled in Medicare who have full 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 aid allowance, eyewear allowance, and $60 for over-the-counter (OTC) items monthly.


Available in the following counties:  Bronx, Dutchess, Kings, Queens, New York, Nassau, Orange, Putnam, Rockland, Suffolk, Sullivan, Ulster, and Westchester


Provider Network: VIP Bold


Level of Extra Help Premium
0% $42.40
25% $31.86
50% $21.20
75% $10.60
100% $0.00

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 aids: $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.


Plan Documents

Medicare HMO Provider & Pharmacy Directories

Health Insurance Plan of Greater New York (HIP) is an HMO/HMO D-SNP plan with a Medicare contract and a contract with the New York State Department of Health. Enrollment in HIP depends on contract renewal. HIP is an EmblemHealth company.

SilverSneakers and the SilverSneakers shoe logotype are registered trademarks of Tivity Health, Inc. © 2021 Tivity Health, Inc. All rights reserved. All rights reserved. Teladoc and related marks are trademarks of Teladoc Health, Inc. and are used by EmblemHealth with permission.

You will need the Adobe® Acrobat Reader software to view files in the Portable Document Format (PDF). If you don’t already have it, you can download a copy from Adobe® here.

Last Update 10/01/2021

Y0026_ 201700