Our VIP Value plan offers benefits and extras to help you stay healthy. It’s a smart choice if you want a $0 monthly premium.
Medicare Advantage
EmblemHealth VIP Value (HMO-POS)
*Your over-the-counter (OTC) card includes a quarterly allowance that can be used to purchase eligible health-related items.
Quality Care With $0 Premiums
Get care from top doctors and hospitals in our VIP Bold Network, plus prescription drug coverage. With a $0 premium and no deductible, this plan helps keep your monthly costs low.
Medical deductible: $0
Maximum out-of-pocket: $7,500
| Plan Features | VIP Value |
|---|---|
| Monthly Premium | $0 |
| Network | VIP Bold |
| Plan Service Area | Available in the following counties: Albany, Broome, Columbia, Delaware, Dutchess, Greene, Orange, Rensselaer, Saratoga, Schenectady, Warren, Washington |
| Summary of Benefits and Coverage | View PDF |
| Show More | |
| Primary Care Provider (PCP) Visit | $0 copay |
| Specialist Visit | $35 copay |
| Preventive Care | $0 copay |
| Dental Services | Up to $2,000 per year, in and out of network Preventive: $0 copay; Comprehensive: 50% of the cost |
| Urgently Needed Services | $40 copay |
| Emergency Care | $115 copay |
| Inpatient Hospital Coverage | $450 per day for days 1–5 $0 per day for each additional day |
| Ambulatory Surgery Center Visit | $0 copay for diagnostic colonoscopy $200 copay for other ambulatory surgery center services |
| Outpatient Facility Services | $0 copay for diagnostic colonoscopy $350 copay for other outpatient hospital services |
| Lab Services | $0 or $15 copay* |
| X-rays | $25 or 20% of the cost* |
| Foot Care | $25 copay |
| Routine Eyewear | Up to $300 every year |
| Hearing Aids | Up to $3,000 every three years |
| Acupuncture | $35 copay for chronic lower back pain, limited to 12 visits |
| Teladoc® | $0 copay |
| Fitness Program | SilverSneakers® membership at no additional cost |
| Over-the-Counter (OTC) Card | $80 per quarter |
| Show Less | |
*Lower cost when services are provided in a doctor’s office or independent facility.
For a complete list of covered services, see the Evidence of Coverage (EOC).
Drug deductible: $215; for Tiers 3, 4, and 5
Initial coverage stage: $0 - $2,100
| Tier | Retail Pharmacy (30-Day Supply) | Mail-Order Pharmacy |
|---|---|---|
| Tier 1 Preferred Generic | $0 copay | 30-day supply: $0 copay 90-day supply: $0 copay |
| Tier 2 Generic | $10 copay | 30-day supply: $0 copay 90-day supply: $0 copay |
| Tier 3 Preferred Brand | 25% of the cost | 30-day supply: 22% of the cost 90-day supply: 22% of the cost |
| Tier 4 Non-Preferred Drugs | 28% of the cost | 30-day supply: 25% of the cost 90-day supply: 25% of the cost |
| Tier 5 Specialty | 29% of the cost | 30-day supply: 29% of the cost 90-day supply: n/a |
| Tier 6 Select Care Drugs | $0 copay | 30-day supply: $0 copay 90-day supply: $0 copay |
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.
Out-of-network/non-contracted providers are under no obligation to treat Plan members, except in emergency situations. Please call our customer service number or see your Evidence of Coverage for more information, including the cost-sharing that applies to out-of-network services.
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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