Our VIP Core plan offers benefits to help you stay healthy and manage your healthcare costs.
Medicare Advantage
EmblemHealth VIP Core (HMO)
Quality Care With Low or No Copays
Get care from trusted doctors and hospitals in our VIP Bold Network with no referrals required. With $0 copays for preventive care visits, this plan helps keep your costs low when you go to the doctor.
Medical deductible: $0
Maximum out-of-pocket: $9,850
| Plan Features | VIP Core |
|---|---|
| Monthly Premium | $180 ($139.50 with Extra Help) |
| Network | VIP Bold |
| Plan Service Area | Available in Kings County |
| Summary of Benefits and Coverage | View PDF |
| Show More | |
| Primary Care Provider (PCP) Visit | $0 copay |
| Specialist Visit | $35 copay |
| Preventive Care | $0 copay |
| Urgently Needed Services | $40 copay |
| Emergency Care | $115 copay |
| Inpatient Hospital Coverage | $399 per day for days 1–6 $0 per day for each additional day |
| Ambulatory Surgery Center Visit | $0 copay for diagnostic colonoscopy $225 copay for other services |
| Outpatient Facility Services | $0 copay for diagnostic colonoscopy $399 copay for other services |
| Lab Services | $0 or $15 copay* |
| X-rays | $25 copay or 20% of the cost* |
| Foot Care | $35 copay |
| Teladoc® | $0 copay |
| 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: $650; for Tiers 3, 4, and 5
Initial coverage stage: $0 - $2,400
| 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 | $2 copay | 30-day supply: $0 copay 90-day supply: $0 copay |
| Tier 3 Preferred Brand | 20% of the cost | 30-day supply: 18% of the cost 90-day supply: 18% of the cost |
| Tier 4 Non-Preferred Drugs | 25% of the cost | 30-day supply: 23% of the cost 90-day supply: 23% of the cost |
| Tier 5 Specialty | 25% of the cost | 30-day supply: 25% 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 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 plan with a Medicare contract. Enrollment in HIP depends on contract renewal. HIP is an EmblemHealth company.
Every year, Medicare evaluates plans based on a 5-star rating system.
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: 10/01/2026
Y0026_203227_M