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Neighborhood Care

EmblemHealth VIP Dual Reserve (HMO D-SNP)

This is a special needs plan (HMO D-SNP) for people enrolled in Medicare and who have full New York State Medicaid. Since you have Medicaid, you qualify for Extra Help and pay $0 each month for this plan. You pay $0 for covered services in this plan. This plan utilizes our VIP Reserve network of providers.

You will also get benefits Medicare does not cover, like $20 monthly for over-the-counter (OTC) items.

 

Available in the following counties:  Bronx, Kings, New York, and Queens


Provider Network: VIP Reserve

 

Plan Option Premium
EmblemHealth VIP Dual Reserve $0.00

Quick Links

Plan Highlights

If you have questions, please call 800-859-4880 (TTY: 711). From Oct. 1 to March 31, you can call us from 8 a.m. to 8 p.m., seven days a week. From April 1 to Sept. 30, you can call us from 8 a.m. to 8 p.m., Monday through Friday. 

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: Preventive and Comprehensive
Hearing aids: Not Covered
Routine eyewear: up to $500 every year
24-hour Nurse Line: Yes
SilverSneakers®: Not covered
Prescription drug: Yes

Drug Coverage

Having the prescription drugs 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 prescription drugs 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.

     Initial Coverage
$0-$2,000 – 30-Day Supply 

You Pay		 Catastrophic

You Pay
Annual Deductible

$0

$0

Generic Drugs

$0 or $1.60 or $4.90

Depends on your level of extra help

Brand Drugs

Brands: $0 or $ 4.80 or $12.15

Depends on your level of extra help

$0 for most adult Part D vaccines, including shingles, and some travel vaccines.

Set up Home Delivery and Refills for Prescription Drugs

Have your prescriptions and refills delivered directly to your home through Express Scripts, Inc. (ESI), our home-delivery pharmacy.

Additional Pharmacy Information

Learn more about how to get money back for a drug, our Medication Therapy Management program, and much more.

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 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. For more information, contact the plan. Teladoc and related marks are trademarks of Teladoc Health, Inc. and are used by EmblemHealth with permission.

Because you qualify for extra help, you get reduced Part D cost-sharing benefits when you enroll.

Free language assistance services are available at 877-344-7364 (TTY: 711)

Last Update 10/01/2024

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VIP Dual Reserve (HMO D-SNP) 2025