Our VIP Dual Enhanced plan offers benefits and extras to help you stay healthy. It may be right for you if you’re currently enrolled in an EmblemHealth Enhanced Care plan and are eligible for both Medicare and Medicaid.
Medicare Advantage
EmblemHealth VIP Dual Enhanced
(HMO D‑SNP)
Quality Care With Coordinated Coverage
This is a Highly Integrated Dual Eligible Special Needs Plan (HIDE SNP) that helps your Medicare and Medicaid coverage work well together. Get care from top doctors and hospitals in our VIP Bold Network with no referrals required, plus prescription drug coverage.
Medical deductible: $0
Maximum out-of-pocket: $9,250
| Plan Features | VIP Dual Enhanced |
|---|---|
| Monthly Premium | $0 |
| Network | VIP Bold |
| Plan Service Area | Available in the following counties: Bronx, Kings, New York, Queens |
| 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 |
| Acupuncture | $0 copay for chronic lower back pain, limited to 12 visits |
| Teladoc® | $0 copay |
| Show Less | |
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 Enhanced 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 Medicare
Find important information about Medicare and what sets EmblemHealth apart.
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.
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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