GHI Senior Care | EmblemHealth

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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. This plan supplements your Medicare benefits.

You will have a deductible to pay before your plan starts to pay. Preventive care, such as you annual physical, are fully covered, with no out-of-pocket costs. With this plan, Senior Care will cover the services below.

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Plan Details

Effective Jan. 1, 2022, after you have met your annual $233 Medicare Part B and $50 Senior Care deductibles, some services will also have a $15 copay.   

You will continue to have a $25 annual deductible for private duty nursing (PDN), durable medical equipment (DME), and ambulance services. Your annual maximum benefit for all three services is $2,500. 

Below are some commonly used services that will now have a $15 copay.*

  • Office visits (PCP or Specialist)
  • In-home nursing services
  • X-rays
  • Laboratory tests
  • Allergy testing/injections
  • Chiropractic services (Medicare covered)
  • Podiatry (Medicare covered)
  • Mental health and substance abuse treatment
  • Urgent care 
  • Physical, occupational, and speech therapy
  • Cardiac rehabilitation services
  • Pulmonary rehabilitation services
  • Complex diagnostic test and radiology
  • Radiation therapy
  • Vision care (Medicare covered)

*Please note this is not a full list. For specific benefit questions, call the number on the back of your member ID card.

You can enhance your Senior Care program with the following services:

  • Enhanced Medicare Part D benefits for prescriptions received at network pharmacies and home delivery service
  • Increased inpatient hospital benefit to 365 days (underwritten by and provided through Empire BlueCross BlueShield)

 

Plan Documents

Provider Coverage

With our robust network of quality doctors, you can get care from many of the region’s leading doctors, clinicians and facilities, including hospitals and urgent care centers.

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The Right Care, Right in Your Neighborhood

AdvantageCare Physicians are the newest addition to the EmblemHealth family and are now one of the largest primary and specialty care practices in New York City. With 37 locations throughout New York City and Long Island, you can find a convenient location near home or work.