EmblemHealth VIP Dual (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.

You will also get benefits Medicare does not cover, like preventive and comprehensive dental, hearing aid allowance, eyewear allowance, $0 for 10 additional acupuncture visits, a SilverSneakers® membership, and $40 monthly for over-the-counter (OTC) items. 

 

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

 

Provider Network: VIP Bold

Plan Option Premium
EmblemHealth VIP Dual $0.00

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 (services that keep you healthy): $0
Urgently needed services: $0
Emergency room: $0
Inpatient hospital coverage: $0
Lab services: $0
X-rays: $0
Type of Care Copay
Foot care: $0
Dental services (no annual dollar limit): Preventive and Comprehensive
Hearing aids: Up to $300 every 3 years
Routine eyewear: Up to $150 every two years
24-Hour Nurse Line: Yes
SilverSneakers®: Yes
Prescription drugs: 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-$2,100 – 30-Day Supply 
Catastrophic Coverage
Annual Deductible

$0

$0

Generic Drugs

$0 or $1.60 or $5.10

Depends on your level of extra help

Brand Drugs

$0 or $ 4.90 or $12.65

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 Amazon Pharmacy or Express Scripts, Inc., our preferred mail-order pharmacy.

 

Plan Documents

  • Summary of Plan Benefits
  • Evidence of Coverage

    Coming Soon

  • LIS Plan Summary
  • EmblemHealth Medicare Star Ratings

    Coming Soon

  • Preventive and Comprehensive Dental Benefits

  • Annual Notice of Changes

Health Insurance Plan of Greater New York (HIP) is an HMO/HMO-POS plan with a Medicare contract and 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. 

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

SilverSneakers is a registered trademark of Tivity Health, Inc. © 2025 Tivity Health, Inc. All rights reserved

Teladoc and related marks are trademarks of Teladoc Health, Inc. and are used by EmblemHealth with permission.

Last Update 10/01/2025

Y0026_203227_M

We use cookies on this website to give you the best experience and to measure website usage. By continuing to use this website, you consent to these cookies. View our Privacy Policy here.