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GHI Senior Care

If you are a retiree with Medicare Parts A and B, you can enroll in our GHI Senior Care program. Senior Care is a supplemental insurance that works with your Medicare Part B benefits. That means this plan pays some of your Medicare Part B costs after Medicare pays its share and you pay your annual deductibles and other applicable cost sharing.

Here’s how it works:

  • For 2026, the Medicare Part B deductible is $283 – you will have to pay that amount before Medicare Part B begins to pay (then Medicare Part B usually pays 80% of your outpatient medical costs). Some preventive services are covered in full by Medicare when the provider accepts Medicare assignment and you are not responsible for deductibles, copays, or coinsurance. For example, colorectal and breast cancer screenings and annual wellness exams.
  • The Senior Care plan has a $50 deductible that you will need to pay in addition to the Medicare Part B deductible.
  • After you have paid $333 ($283 Medicare Part B deductible plus $50 Senior Care deductible), you will pay a $15 copay for most Senior Care-covered services (see list below). Medicare Part B typically pays for 80% of your medical costs, with Senior Care covering the remaining 20%, less the $15 copay (or other applicable cost sharing), which you pay.

View GHI Senior Care Medicare Part D plan information here

Enollment and Customer Service 212-501-4444 (TTY: 711)
8 a.m. to 6 p.m., Monday through Friday.

Senior Care Copays

After you’ve paid your Medicare Part B and Senior Care deductibles, most commonly used services are covered with a copay. Please note:

  • The service must have been covered by Medicare Part B to be eligible for coverage by Senior Care.
  • Copays are limited to one copay per provider per date of service. For example, if you see a doctor and get a test on the same day, you potentially could have one $15 copay for the visit with the doctor, a second for a laboratory test if done outside the doctor’s office, and a third for the facility where the visit and test took place.
Benefit Copay per visit
Primary care physician (PCP) office visits $15
Specialist office visit $15
Allergy testing/injections $15
X-rays $15
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Plan Documents

 

Certificate of Insurance

Your Certificate of Insurance describes the benefits available under the group contract.
For Senior Care members, see Section XV “Coverage for Medicare Eligible Individuals,” paragraph 2, for a description of covered services and cost sharing.

  • EHPI/GHI CBP* Certificate of Insurance, Base Plan

  • EHPI/GHI CBP Certificate of Insurance - Base Plan + Enhanced Rider, Less Rx

  • EPHI/GHI CBP Certificate of Insurance, Base Plan + Enhanced Rider + Rx

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AdvantageCare Physicians New York is one of the largest primary and specialty care practices in New York City with 35+ locations. 

*EmblemHealth Plan Inc./Group Health Incorporated Comprehensive Benefits Plan.

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