The EmblemHealth Difference for Medicare Advantage | EmblemHealth

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The EmblemHealth Difference

Based on more than 80 years of experience, EmblemHealth has designed great Medicare plans for the needs of New Yorkers. We offer many low-cost Medicare plans - some even at $0 - with a wide range of benefits. And we have large networks of doctors, health care professionals and hospitals to give you the care you need.

EmblemHealth sets itself apart from the competition through a combination of experience, personalized service, a choice of plan options and our large hospital and provider networks.

We offer a wide variety of Medicare plan choices that all include Part D prescription drugs. EmblemHealth Medicare Plans are Medicare Advantage Health Maintenance Organization (HMO) plans. With an HMO plan, you choose a doctor who will provide your everyday care called a primary care doctor. This doctor will arrange for you to see specialists and get services. EmblemHealth Medicare plans work with large networks of leading health care professionals and facilities that contract with the plan. You are usually only covered for care and services you get from this network. In an emergency, you can go to any doctor or hospital.

Over the years, we've worked hard to provide people like you with the choices they need to receive excellent care. Search for a Doctor, Dentist, Hospital or Other Health Care Service in the EmblemHealth Medicare HMO plans.

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Out-of-network/non-contracted providers are under no obligation to treat EmblemHealth 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.

Stay Healthy. Get Well. Live Better.

We offer the following programs and resources to help you best manage your health.

24 Hour Nurse Hotline

We offer all our EmblemHealth VIP HMO and D-SNP plan members the 24 Hour Nurse Hotline. The 24 Hour Nurse Hotline is staffed by highly trained registered nurses. They will guide you in making informed decisions about everyday health issues. They will also work with you on how best to handle a medical concern.

The program also helps as an "early warning system" for health conditions before they may need a doctor visit, emergency room visit or a hospital stay

Members can call the 24 Hour Nurse Line at 877-444-7988, 24 hours/seven days a week. If you use a TTY, please call 711.

EmblemHealth Care Management Programs

For eligible members, care management is available as part of your health benefits at no extra cost to you. These programs include education and support by phone or face to face with one of our care managers to help manage a chronic condition. They add to the care already provided by your doctor by helping you better understand your condition.

Our Care Management Programs work to help you take control of your health by:

·         Helping you understand your condition.

·         Improving your discussions about your health and safety with your doctors.

·         Show you how to make changes in your life that will keep your condition under control.

·         Finding ways for you to stay healthy and safe.

·         Working with your doctor on your treatment plan.

·         Give you a chance to tell us about your experience with the program.

When you enroll in one of our programs you may:

·         Work one-on-one with any of our nurses, social workers, or behavioral health care specialists by phone.

·         Get free educational materials about:

·         Your health symptoms and how to care for them.

·         Health and safety risks.

·         Treatments.

·         Diet and nutrition.

·         And more.

·         Find support services that are in your community.

For more information about our Care Management programs, members please call 800-447-0768, Monday to Friday from 9 a.m. to 5 p.m. If you use a TTY, please call 711. For ID cards with Montefiore logo please call 844-209-4932, Monday to Friday from 8:30 am to 5 pm. If you use a TTY, please call 711.

EmblemHealth’s Care for the Family Caregiver initiative provides information, resources and tools to help our members and others manage the challenges of caring for a loved one, including self-care.

AdvantageCare Physicians, EmblemHealth’s partner, delivers quality primary and specialty care throughout New York City and Long Island. They provide a personal approach by surrounding you with a Care Team. Your Care Team consists of a doctor, nurse, medical assistant and patient service representative who work together to focus on helping you achieve and maintain your best health.

EmblemHealth Neighborhood Care provides in-person customer service, sales and health and wellness support at eight locations across New York City. From enrollment seminars to help with translating paperwork, Neighborhood Care lets EmblemHealth members make the most of their benefits.

We also speak multiple languages including Spanish, Mandarin, Cantonese, Fuzhounese, and Creole.

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Last Updated: 10/1/19

Y0026_ 127364 Accepted 10/1/19