Important Plan Documents

Members 2020 Important Plan Documents

Your important plan documents below include coverage and costs for medical product and services and prescription drugs that will start on January 2020.

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  • EmblemHealth VIP Comprehensive/Preventive Dental



  • Medicare HMO Dental Directory



Formulary

List of Covered Drugs


Prior Authorization

Prior Authorization means that you will need to get approval from your plan before you fill your prescriptions. If you do not get an approval, your plan may not cover the drug. Below is a list of drugs that require prior-authorization.

  • 2020 EmblemHealth Medicare Part D Prior Authorization (HMO)


Step Therapy

Step Therapy means you may need to try a different or more common drug first. Below is a list of drugs that require Step Therapy.

  • 2020 EmblemHealth Medicare Part D Step Therapy




  • Evidence of Coverage (EOC)

  • Provider or Pharmacy Directory

  • Formulary (List of Covered Drugs)

Nondiscrimination Policy 

Notice of Nondiscrimination Policy

 

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Last Updated 10/1/19

Y0026_ 127364 Accepted 10/1/19