Our VIP Dual plan offers a range of benefits and extras to help you stay healthy. If you’re eligible for both Medicare and Medicaid, this plan may be right for you.
Medicare Advantage
EmblemHealth VIP Dual (HMO D-SNP)
*Your over-the-counter (OTC) card includes a monthly allowance that can be used to purchase eligible health-related items.
Quality Care and Affordable Prescriptions
This is a Dual Eligible Special Needs Plan (D‑SNP) for members with both Medicare and Medicaid coverage. Get care from top doctors and hospitals in our VIP Bold Network with no referrals required, plus prescription drug coverage with low or no copays.
Medical deductible: $0
Maximum out-of-pocket: $9,250
| Plan Features | VIP Dual |
|---|---|
| Monthly Premium | $0 |
| Network | VIP Bold |
| Plan Service Area | Available in the following counties: Albany, Broome, Columbia, Delaware, Dutchess, Greene, Nassau, Orange, Putnam, Rensselaer, Richmond, Rockland, Saratoga, Schenectady, Suffolk, Sullivan, Ulster, Warren, Washington, Westchester |
| Summary of Benefits and Coverage | View PDF |
| Show More | |
| Primary Care Provider (PCP) Visit | $0 copay |
| Specialist Visit | $0 copay |
| Preventive Care | $0 copay |
| Dental Services | Preventive and comprehensive coverage with no annual dollar limit |
| Urgently Needed Services | $0 copay |
| Emergency Care | $0 copay |
| Inpatient Hospital Coverage | $0 copay |
| Ambulatory Surgery Center Visit | $0 copay for diagnostic colonoscopy $0 copay for other ambulatory surgery center services |
| Outpatient Facility Services | $0 copay for diagnostic colonoscopy $0 copay for other ambulatory surgery center services |
| Lab Services | $0 copay |
| X-rays | $0 copay |
| Foot Care | $0 copay |
| Routine Eyewear | Up to $150 every two years |
| Hearing Aids | Up to $300 every three years |
| Acupuncture | $0 copay for chronic lower back pain, limited to 12 visits Plus, 10 additional visits for other eligible conditions |
| Teladoc® | $0 copay |
| Fitness Program | SilverSneakers® membership at no additional cost |
| Over-the-Counter (OTC) Card | $40 per month |
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For a complete list of covered services, see the Evidence of Coverage (EOC).
Drug deductible: $0 annually
Initial coverage stage: $0 - $2,100
| Prescription Drug Type | VIP Dual Coverage |
|---|---|
| Generic Drug (30-Day Supply) | $0 or $1.60 or $5.10 Depending on your level of Extra Help |
| Brand Drug (30-Day Supply) | $0 or $4.90 or $12.65 Depending on your level of Extra Help |
You pay $0 for most adult Part D vaccines, including shingles and some travel vaccines.
See more EmblemHealth Medicare Advantage plan options.
Helpful Resources
Tools and information to help you manage your care and coverage.
Learn about our Member Rewards Program to earn rewards for making the right health care choices.
Learn About Medicare
Find important information about Medicare, what sets EmblemHealth apart, and how to enroll when you’re ready.
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. © 2026 Tivity Health, Inc. All rights reserved
Teladoc and related marks are trademarks of Teladoc Health, Inc. and are used by EmblemHealth with permission.
Last Updated: 06/30/2026
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