Healthy Futures Program
Whether planning a family or already pregnant, having the right care and support helps ensure a safe and healthy pregnancy. Our Healthy Futures Program is a great resource that connects members to important health information, so they feel supported through their pregnancy journey.
Healthy Futures is free for EmblemHealth members, and it offers:
- Weekly emails with pregnancy tips, resources, and program updates starting from 20 weeks all the way through delivery and postpartum care. These emails will include nutritious recipes, tips to increase your physical activity, what to pack in your hospital bag, and more.
- Free access to question-and-answer sessions with EmblemHealth’s medical experts, virtual meet-ups with other moms and moms-to-be, and online classes with Neighborhood Care.
- Toll-free telephone access to a nurse who can answer questions about pregnancy, child care, family planning, and more. Members can call 877-444-7988, 24 hours a day, seven days a week throughout their pregnancy, and up to six weeks after their baby is born.
- Three surveys done – two obstetrical risk surveys throughout pregnancy and one post-partum survey with a care management staff.
- A free EmblemHealth onesie.
Tobacco-Free Quit-Smoking Program
EmblemHealth has partnered with the New York State Smokers Quitline (NYSSQL) to provide comprehensive smoking cessation services. NYSSQL is a state program based at the Roswell Park Cancer Institute in Buffalo, New York. The program is available at no cost to all New York State residents.
Services available through the NYSSQL include:
- Help developing a quit plan by phone from trained quit-smoking experts.
- Recorded phone messages and tips available 24 hours a day, seven days a week.
- Receipt of educational guides and materials by mail.
- A two-week supply of nicotine replacement therapy (nicotine patch or gum) for those who qualify.
- Access to information and services through the New York State Quitline website.
The Tobacco-Free Quit-Smoking Program is also implemented by Roswell Park. In addition to the NYSSQL benefits for New York residents, eligible EmblemHealth members ages 18 and older enrolled in the Tobacco-Free Quit-Smoking Program receive the following services:
- Full coverage for smoking cessation medication (nicotine patch, gum, lozenge, bupropion [generic Zyban®], and Chantix®) for members with EmblemHealth pharmacy benefit coverage enrolled in the Tobacco-Free Quit-Smoking Program within one year of program enrollment. Medicare members are responsible for a copay for the smoking-cessation prescription products.
- Unlimited one-on-one support and help developing a quit plan by phone from trained quit-coach experts.
Practitioners are encouraged to refer members directly to the New York State Smokers Quitline at 866-NY-QUITS (866-697-8487), or 311 in New York City. Referral forms can be found online at nysmokefree.com. For out-of-state members, referrals can be made directly to the program by calling 877-500-2393.
Studies show that a follow-up visit or phone call within one week of the patient's quit date can double the effectiveness of any intervention. EmblemHealth provides reimbursement for smoking-cessation counseling based on current Centers for Medicare & Medicaid Services guidelines. We reimburse for CPT codes 99406 and 99407.
Healthy Living Program
EmblemHealth provides many tools to help members manage their weight. Visit the Provider Weight Management Resources section of emblemhealth.com for information about:
- Body mass index (BMI)
- Clinical practice guidelines
- Screening recommendations
- Coding and tools
Centers of Excellence (COE) Program
Select EmblemHealth members with serious injuries or illnesses related to cancer or orthopedics and musculoskeletal conditions have access to our industry-leading hospital partners, Memorial Sloan Kettering Cancer Center and Hospital for Special Surgery. EmblemHealth’s care management programs work collaboratively with the COE care teams to provide care coordination to address member needs.
EmblemHealth chose these Centers of Excellence partners after a competitive evaluation process because they are as committed as we are to meet the needs of our members. These top hospitals and doctors are nationally recognized for their high-quality, patient-focused care and best-in-class research, training, and technology standards. They have many convenient locations throughout Manhattan, Long Island, Westchester, and New Jersey.
Managing Entity Care Management Programs
SOMOS, Montefiore (CMO), and HealthCare Partners (HCP) offer care management programs for EmblemHealth members who receive treatment under their care. For questions or more information about their care management programs, call:
- SOMOS at 855-225-3211.
- CMO at 844-209-4932 (TTY: 711) from 9 am. to 5 p.m., Monday to Friday.
- HCP at 800-877-7587 (TTY: 711) available 24/7.