Medicare Supplement Insurance Plans Coverage Details | EmblemHealth

Medicare Supplement Plan Details

Enrolling in a Medicare Supplement Plan

Medicare Supplement Insurance is open for enrollment all year long. We’ve made enrolling as easy as possible. See below for eligibility and enrollment information.

Medicare Part A covers some hospital services, while Medicare Part B covers some medical services, but they don’t cover all costs. That’s why some people with Medicare choose to add a Medicare Supplement Insurance Plan offered by EmblemHealth.

It “supplements” Medicare by covering the bills that are only partially covered by Medicare Parts A and B.

At EmblemHealth, we offer six Medicare Supplement Insurance plans. You choose the plan with the benefit design that suits your needs. Benefits provided will depend upon the plan you select, and premiums may vary by plan and by region.

All EmblemHealth Medicare Supplement plans cover the following Basic Benefits:

  • Hospitalization: EmblemHealth pays Part A coinsurance* plus coverage for 365 additional days in your lifetime after Medicare stops paying.
  • Medical Expenses: EmblemHealth pays Part B coinsurance* (20 percent of Medicare-approved expenses), Medicare pays 80 percent.
  • Blood: First three pints of blood each year.
  • Hospice care: EmblemHealth pays Part A coinsurance*.

* Coinsurance is the percentage of the Medicare approved expenses that you pay.

Benefits provided will depend upon the plan you select, and premiums may vary by plan and by region.

Monthly Premium Rates
Each rating region consists of the noted counties. Rates and benefits are subject to change. Please refer to your contract or contact EmblemHealth for additional information, including limitations and exclusions.

We, Group Health Incorporated, an EmblemHealth company (hereafter referred to as “EmblemHealth”) can only raise your premium if we raise the premium for all policies like yours in this geographic region.

EmblemHealth Medicare Supplement Insurance 2019 monthly premium rates (per individual):

Region Plan A Plan B Plan C Plan F Plan F+

Albany

$185.48

$242.45

$288.56

$508.59

$71.46

Buffalo

$175.46

$229.40

$272.95

$481.07

$67.43

Downstate

$194.87

$253.28

$300.87

$530.59

$74.00

Mid-Hudson

$185.48

$242.45

$288.56

$508.59

$71.46

Rochester

$175.46

$229.40

$272.95

$481.07

$67.59

Syracuse

$181.39

$237.12

$282.08

$497.18

$69.86

Utica/Watertown

$175.46

$229.40

$272.95

$481.07

$67.59

The following is a breakdown of counties in each region:

 

Albany:

Albany, Clinton, Columbia, Essex, Fulton, Greene, Montgomery, Rensselaer, Saratoga, Schenectady, Schoharie, Warren and Washington

Buffalo:

Allegany, Cattaraugus, Chautauqua, Erie, Genesee, Niagara, Orleans and Wyoming

Downstate:

Bronx, Kings, Nassau, Manhattan, Queens, Richmond, Rockland, Suffolk and Westchester

Mid-Hudson:

Delaware, Dutchess, Orange, Putnam, Sullivan and Ulster

Rochester:

Livingston, Monroe, Ontario, Seneca, Wayne and Yates

Syracuse:

 

Broome, Cayuga, Chemung, Cortland, Onondaga, Schuyler, Steuben, Tioga and Tompkins

Utica/Watertown:

Chenango, Franklin, Hamilton, Herkimer, Jefferson, Lewis, Madison, Oneida, Oswego, Otsego and St. Lawrence

Applicants must be from New York State to be eligible for coverage under one of these plans.

When Coverage Begins

Once you send in your completed application with the first payment, we will verify your eligibility and send you an identification card, a contract along with the schedule page, which will show you the effective date of your coverage.

 

2019 Medicare Supplement Brochure — Helpful information for beneficiaries.

2019 Medicare Supplement Benefit Chart

All EmblemHealth Medicare Supplemental plans cover the following basic benefits:

  • Hospitalization: EmblemHealth pays Part A coinsurance* plus coverage for 365 additional days in your lifetime after Medicare stops paying.
  • Medical Expenses: EmblemHealth pays Part B coinsurance* (20 percent of Medicare-approved expenses), Medicare pays 80 percent.
  • Blood: First three pints of blood each year.
  • Hospice care: EmblemHealth pays Part A coinsurance.*

 

In addition to the Basic Benefits, Plan B also covers

  • Part A inpatient deductible** per benefit period: $1,364 in 2019.

 

In addition to the Basic Benefits, Plan C also covers

  • Coinsurance* for skilled nursing facility care.
  • Part A inpatient deductible** per benefit period: $1,364 in 2019.
  • Part B annual deductible***: $185 in 2019.
  • Emergency care rendered during the first 60 days of foreign travel.

 

In addition to the Basic Benefits, Plan F also covers

  • Coinsurance* for skilled nursing facility care.
  • Part A inpatient deductible** per benefit period: $1,364 in 2019.
  • Part B annual deductible***: $185 in 2019.
  • 100% of Part B costs above what Medicare will pay.
  • Emergency care rendered during the first 60 days of foreign travel.

 

In addition to the Basic Benefits, Plan F+ also covers

  • Coinsurance* for skilled nursing facility care.
  • Part A inpatient deductible** per benefit period: $1,364 in 2019.
  • Part B annual deductible***: $185 in 2019.
  • 100% of Part B costs above what Medicare will pay.
  • Emergency care rendered during the first 60 days of foreign travel.
  • SilverSneakers® membership

Plan F+ is a high deductible plan that pays the same benefits as Plan F after one has paid a calendar year deductible of $2,300 in 2019



* Coinsurance is the percentage of the Medicare approved expenses that you pay.

** Part A inpatient deductible is the amount you pay for Medicare Part A hospitalization services, including semi-private room and board, general nursing and other services and supplies during the first 60 days of a hospital stay covered by Medicare.

*** Part B annual deductible is the amount you pay for health care outside of the hospital before your plan starts to pay.

Eligibilty

Medicare Supplement Insurance is open for enrollment all year long. To apply for coverage under one of EmblemHealth’s Medicare Supplement Insurance Plans, you must:

  • Be eligible for Medicaremade enrolling as easy as possible. To apply for an EmblemHealth Medicare Supplement plan
  • Reside in New York State
  • Not have coverage provided by Medicaid
  • Not have coverage by any other health insurance plan

 

You may apply for an EmblemHealth Medicare Supplement Insurance Plan if your current coverage is ending and you want to change your plan. You can do this if you have EmblemHealth insurance or another insurance plan.

When Benefits Begin

Once you send in your completed application with the first payment, we will verify your eligiblity and send you an identification card, a contract along with the schedule page, which will show you the effective date of your coverage.

When Benefits Begin for Current EmblemHealth Members

Coverage usually begins immediately after your previous EmblemHealth plan ends so that there is no break in your coverage. Simply complete the application and return it within 60 days of the end of your previous coverage in order for your Medicare Supplement plan to take effect on the termination date.

You may apply after the 60-day period, but you may have a break in coverage.

How to Enroll

We’ve made enrolling as easy as possible. To apply for an EmblemHealth Medicare Supplement plan, complete and return the application found in the link below, along with a check for the first payment to us.

If you do not send a payment with your application, we will send you an invoice after the application is processed, once your eligibility has been confirmed.

We will send you an identification card along with your contract within 7-10 business days after all parts of the application have been received and the premium has been paid, unless you request a later effective date.

EmblemHealth Medicare Supplement Application Form


Mail the form to:

EmblemHealth
PO Box 2820
New York, NY 10016-2820

Medicare Supplement Plans

You Have Options

At EmblemHealth, we offer a wide range of Medicare Supplement insurance plans. You choose the plan with the benefit design that best suits your needs. 

Last Updated 10/29/18

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