HIP HMO Preferred Plan Wellness Program & Rewards | EmblemHealth

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Wellness and Rewards Programs

Wellness Program with Personalized Guidance from Trained Coaches

Achieve your healthiest self. Our wellness program* is tailored to your needs, and in order to match you with the perfect coach, we'll need you to answer a few health questions. Sign in to the member portal to take our questionnaire, or read more about the program below.

 

Wellness Program Basics

You deserve to be healthy and stay healthy. That’s why our Wellness Program is dedicated to helping you thrive. Our Wellness Program is not one size fits all. It’s voluntary and personalized for you.

Do you have goals for your health and wellness, but have a hard time making a lasting change? Want to exercise more, lose weight, or eat healthier?

 

Our health coaches will support you to help you live your healthiest life. They’ll work together with you to identify the changes you’d like to see, and then help you make actionable goals to reach them. They’re trained holistically and will help you make changes to your activity pattern, nutritional intake, sleep pattern and stress management skills, and more to help you achieve your goals.

 

Do you need more intensive care management to improve your well-being while living with an ongoing health condition? Our coaches will help you live better while managing conditions like asthma, diabetes, heart disease, or chronic obstructive pulmonary disease (COPD). And we even have a team of dedicated care managers to give you extra support if you’ve recently been hospitalized or have a serious health condition.

 

It all starts with you speaking to a Gold Line agent or filling out a Healthy Living questionnaire—a health risk assessment. Just sign in below to connect to our Wellness Program for details. You can also see how to start earning rewards for healthy habits. After you finish your questionnaire, we’ll connect you with help and resources to reach your best life goals—whether that’s access to a health library full of resources to guide you or a health coach.

Track and achieve your goals on our Wellness Program tab.

On our Wellness Program tab, you’ll have many resources at your fingertips. You can:

  • Fill out the Healthy Living questionnaire so a health coach can contact you to set health goals together.
  • Learn about earning rewards for healthy habits.
  • Read helpful articles in the health library.
  • Confirm your healthy activities—like yoga and steps.
  • See how many entries into the Monthly Wellness Program Rewards Drawing you could be eligible for based on your participation in the program.

Plus, you’ll get the support and encouragement you need to achieve your health goals.

Learn more about how we’re taking care of NYC.

Sign in to your member portal to learn about the Wellness Program and get started with your Healthy Living questionnaire. Our Gold Line agents can also share the details about the program and rewards. They’ll even connect you to a health coach. Call our Gold Line at 833-CNY-GOLD (833 269 4653) (TTY: 711) Monday to Friday, 8 a.m. to 8 p.m., and Saturday, 8 a.m. to 1 p.m., for more details.

Completing the survey takes just 20-25 minutes – and you can save your questionnaire at any point if you need to complete it at a later time. Finishing the questionnaire is required for EmblemHealth to connect you with your personalized health coach and care team.

You can call our Gold Line agents at 833-CNY-GOLD (TTY:711) to connect with the health coach that is right for you.

There is no out-of-pocket cost to you. Your health coach is one of the many benefits of your HMO Preferred Plan.

Once you complete your Healthy Living questionnaire, you will have the opportunity to speak individually with your health coach to review your results and determine the milestones that best meet your individual health needs and personalized goals. The good news is that you and your healthy coach can check in regularly on progress and make adjustments as needed.

No, the Wellness Program is part of the benefits and support tools to assist you with managing your health. However, completing the Healthy Living Questionnaire and tracking your healthy habits will make you eligible for the monthly rewards drawing program.

HEALTHY HABITS DESERVE HEALTHY REWARDS

Monthly Wellness Program Rewards Drawing*

Healthy living is a commitment that deserves to be celebrated. And we’re here to make sure you do.

Each month, you and up to 20 other winners could get a $500 gift card to use on things that promote your good health. For certain healthy actions you take—like getting a flu shot, completing your online Healthy Living questionnaire, or getting an age-appropriate checkup—you will be entered into a monthly drawing and be eligible for an annual grand prize. Most drawing entries will carry over every month through the rest of the calendar year. So the more healthy actions you take, the more chances you have to win. With motivation like this, you’ll be on your way to making this year your fittest one yet.

Rewards for healthy habits.

To start immediately earning entries into the monthly drawing, sign in to your member portal and:

  • Choose to Go Paperless For All Options.
  • Take a short Know Your Benefits Training.

On the Wellness Program tab, start taking charge of your health and earn an entry into the monthly drawing with actions like these:

  • Complete your online Healthy Living questionnaire—a health risk assessment.
  • Get your annual flu shot.
  • Go for your age-appropriate checkup, like a mammography or colorectal cancer screening. See Drawing Parameters below for check-ups and services included.**
  • Our Gold Line agents know all about our Wellness Program Rewards. Call our Gold Line at 833-CNY-GOLD (833-269-4653) (TTY: 711) Monday to Friday, 8 a.m. to 8 p.m., and Saturday, 8 a.m. to 1 p.m., for more details.
  • Complete an average of 10,000 steps a day, or 30 minutes of exercise three times a week.
  • If you have a chronic condition, like asthma or COPD, you can complete your fact sheet, engage in our care management program, or visit a physician.

Partner with us to feel your best and get rewarded.

Learn more, including the specific details and rules for the monthly Wellness Program Rewards Drawing. Your progress and drawing entries will be tracked in the Wellness Program. Certain activities are tracked through claims that may take up to 90 days to come in.

 

* Subject to approval by the New York State Department of Financial Services. Participation limited to primary insured and spouse. The Wellness Program begins on January 1, 2019.

**Recommended medical visits for reward entries include:

  • Preventive visits: For members age 19-39, preventive visits should be completed once every three years. For members age 40-49, preventive visits should be completed once every two years. For members over age 50, preventive visits should be completed on an annual basis.
  • Cervical cancer / HPV screening: For female members age 21-65, cervical cancer and HPV screenings should be completed once every three years.
  • Mammogram screening: Female members age 50-74 should receive a recommended mammogram screening once every two years. For patients between 40-50, one baseline screening is recommended during this time.
  • Colorectal cancer screening: Members age 50-70 should receive one of the screening options available, including a colonoscopy and Cologuard® screening.
  • Complete appropriate chronic condition activities: For members with asthma, coronary artery disease, chronic obstructive pulmonary disease, heart disease, hypertension, or diabetes, completing an annual physician exam is recommended.

What is the online Healthy Living questionnaire and how long does it take?

The Healthy Living questionnaire includes a series of questions about your overall health and wellness. It’s a useful way to measure and assess your starting point for achieving your best health. By completing the 20-25 minutes Healthy Living questionnaire located on your EmblemHealth Wellness program portal, you can earn one entry per month as part of the Wellness Program Rewards Drawing. You can save your questionnaire at any point if you need to complete it at a later time. 

What if I don’t have a personal email?

Call our Gold Line at 833-CNY GOLD (833-269-4653) (TTY:711) Monday to Friday, 8 a.m. to 8 p.m. or Saturday, 8 a.m. to 1 p.m. and we can make sure you have access to the information and resources you need.

How do I earn a monthly rewards entry for “Going Paperless?

By selecting the “Go Paperless For All Options” through EmblemHealth’s member portal, you can select to receive all communications from EmblemHealth through email or the member portal. Choosing to “Go Paperless” earns you one entry a month into the Wellness Program Rewards Drawing as long as you maintain the “Go Paperless” selection.

What is the “Know Your Benefits” video and quiz and how do I complete it?

The “Know Your Benefits” video provides a brief and helpful overview of all the benefits associated with your coverage. The video and quiz will be available to all members in January and by reviewing and completing both, you can earn one entry each month until the end of the calendar year. The video and quiz is available through your EmblemHealth member portal.

When do the screenings and other services I receive count toward the rewards drawing and where may I track my entries?

Your progress and drawing entries will be tracked through the Wellness Program and you can check your entries online. Preventive services and screenings received from January 1, 2019 through December 31, 2019 will count toward entries in the drawing. Because certain activities are tracked through claims, it may take up to 90 days to be registered with the Wellness Program.

Once I “Go Paperless” and view the “Know Your Benefits” video, do I have to take any other action for my rewards drawing entries to be counted?

Yes, go to the Wellness Program tab and agree to the terms of participating in the program. Then, for certain healthy actions you take—like getting a flu shot, completing your online Healthy Living Questionnaire, or getting an age-appropriate checkup—you will be automatically entered into the monthly rewards drawing and be eligible for an annual grand prize. Most drawing entries will carry over every month through the rest of the calendar year.

I have a chronic condition and need support managing my health on a daily basis. Are there programs that I can enroll in to provide more direct care and management?

Yes, EmblemHealth has a dedicated team of care managers who can help you manage your chronic condition on a daily basis and develop a long-term plan to achieve your individual goals for better health. You can even win entries into the monthly rewards drawing by completing certain activities to help you get on the track to better health. By completing a survey or reading a fact sheet in the EmblemHealth Wellness Program portal, you are entered into the drawing entry for that month and every month after for the rest of the year.

You can also earn monthly drawing entries by participating in ongoing case management with your health coach and even for completing a medical visit for checking in on your chronic condition. All activities are designed to make managing your health a whole lot easier and more rewarding. Call a Gold Line agent at 833-CNY-GOLD (833-269-4653) (TTY: 711) Monday to Friday, 8 a.m. to 8 p.m., and Saturday, 8 a.m. to 1 p.m., to find out more.

How do I track my steps as part of the monthly Wellness Program Rewards Drawing?

Tracking steps can be a simple way to reach your exercise goals. Check your mobile phone to see if it includes a step tracking program or you may purchase a separate tracking device to adequately measure your steps. You can also earn a rewards entry by completing 30 minutes of exercise three times a week. By tracking your progress on the EmblemHealth Wellness Program, you can earn a rewards entry—one per month—when you complete these activities. Staying fit has never been more fun.

May other members who are on my plan earn Wellness Program Rewards entries for healthy habits?

At this time, HMO Preferred Plan subscribers and their spouses are able to earn entries.

Where can I see more details about the Wellness Program Rewards Drawing?

See the drawing rules and parameters below. You may also call the Gold Line at 833-CNY-GOLD (TTY:711) Monday to Friday, 8 a.m. to 8 p.m. or Saturday, 8 a.m. to 1 p.m., and we can make sure you get your questions answered.

Following are the key activities that will earn you entries into the monthly Rewards Drawing as well as the rules. All City of New York HMO Preferred Plan subscribers and spouses are eligible for the monthly rewards drawing.

 

1.    Member Activity: Complete "Go Paperless" 

  • Where to complete activity: Sign in to emblemhealth.com/gold
  • Eligible Drawing Entries Upon Completing Activity: 1 entry each month
  • Entry lasts until: The member changes their election to do everything paperless
  • Example: The member signs in to emblemhealth.com/gold in January and elects to Go Paperless for all options. The member will earn an entry beginning in January, and for each month as long as they maintain the paperless election. 

 

2.     Member Activity: Complete "Know Your Benefits" video and quiz           

  • Where to complete activity: Sign in to emblemhealth.com/gold
  • Eligible Drawing Entries Upon Completing Activity: 1 entry each month
  • Entry lasts until: The end of the year
  • Example: The member signs in to emblemhealth.com/gold and completes the video and quiz in February. The member will earn an entry for Complete "Know Your Benefits" video beginning in February, and for each month until the end of the calendar year. 

 

3.     Member Activity: Complete on-line Healthy Living Questionnaire

  • Where to complete activity: Sign in to emblemhealth.com/gold go to Wellness Program Eligible Drawing Entries Upon Completing Activity: 1 entry each month 
  • Entry lasts until: The end of the year
  • Examples: 1) Member completes the Healthy Living Questionnaire Health Risk Assessment (HRA) in January. The member will receive the drawing entry beginning in January, and for each month until the end of the calendar year.  (2) Member completes the HRA in March. The member will receive the drawing entry beginning in March, and for each month until the end of the calendar year.

 

4.     Member Activity: Get your flu shot

  • Where to complete activity: Sign in to emblemhealth.com/gold go to Wellness Program Eligible Drawing Entries Upon Completing Activity: 1 entry each month
  • Entry lasts until: The end of the year
  • Examples: (1) The member attests to Get your flu shot in February. The member will receive the drawing entry beginning in February, and for each month until the end of the calendar year. (2) The member attests to Get your flu shot in December 2019 that they received their flu shot. The member will receive the drawing entry for Get your flu shot in December only.

5.     Member ActivityGetting your age-appropriate checkup (See Drawing Parameters for checkups and services included)         

  • Where to complete activity: Member earns the drawing entry after the claim has processed.     
  • Eligible Drawing Entries Upon Completing Activity: 1 per measure each month
  • Entry lasts until: The end of the year
  • Examples: (1) The member gets their preventative checkup in February The claim is not processed until May. The member will get a drawing entry for Getting your age-appropriate checkup starting in May, and for each month until the end of the calendar year. (2) The member gets their preventive visit in February. The claim is processed in April. The member receives a drawing entry for Getting your age-appropriate checkup starting in April, and for each month until the end of the calendar year. The member also gets a mammography in April. The claim processes in May. The member will also receive another drawing entry for Getting your age-appropriate checkup starting in May, and for each month until the end of the calendar year (i.e. the member will receive 1 entry starting in April for the preventative visit, and an additional entry starting in May for the mammography).

 

6.     Member Activity: Complete appropriate Chronic Condition activities (See Drawing Parameters for list of Chronic Conditions)

  • Where to complete activity-A: Completing member goals on factsheet or survey in EmblemHealth Wellness Program platform, or engage in on-going case management. Where to complete activity-B: Physician visit for chronic condition management (claims based).
  • Eligible Drawing Entries Upon Completing Activity: 1 entry each month     
  • Entry lasts until: The end of the year
  • Examples: (1) The member completes the goals fact sheet in January. The member earns a drawing entry starting in January, and for each month until the end of the calendar year. (2) The member is engaged in Care Management starting in April. The member earns a drawing entry starting in April, and for each month until the end of the calendar year.
  • Example (for those completing activity through physician visit for chronic condition management): The member goes to the doctor for their asthma in July. The claim is not processed until October. The member will earn an entry for Complete appropriate Chronic Condition starting in October, and for each month until the end of the calendar year. 

 

7.     Member Activity: Member averages 10,000 steps per day or 30 minutes of exercise activity 3 times a week  

  • Where to complete activity: Member attests in EmblemHealth Wellness Program platform
  • Eligible Drawing Entries Upon Completing Activity: 1 entry the month the steps are uploaded
  • Entry lasts until: The month they upload their steps
  • Examples: (1) The member attests that they completed the requirement (achieved 10,000 steps per day/30 min of activity per week) in the EmblemHealth Wellness Program platform in January, February, and March. The member will earn an entry for each month they attested. (2) The member attests that they completed the requirement (achieved 10,000 steps per day/30 min of activity per week) in January and February. The member will earn an entry for each month they attested. The member forgets to attest in March. The member does not earn an additional entry in March.

NOTES:

* All subscribers and spouses of CNY HMO Preferred plan are eligible to enter the monthly wellness drawing.

** Monthly drawing prizes will be given up to 20 winners. Prizes valued up to $500. Limitation of one winning per member. Members should be encouraged to use the gift card towards a product or service that promotes good health. Examples include purchasing healthy cook books, over the counter vitamins, or exercise equipment.

***Monthly drawings will take place the 20th of each month. Members will receive gift cards electronically. If you do not have a valid email address, please call us at 833-CNY-GOLD (833-269-4653) (TTY: 711).

****One annual Grand Prize will be selected in Dec 2019. All members who participate in the Drawing are eligible. Further details to come.

For keeping up healthy habits, like getting a flu shot or age-appropriate checkup, you can earn entries into a monthly drawing valued at $500. Following are the key activities that are eligible for rewards drawing entries.

Go for Age-Appropriate Check Ups

Preventive Visits

  • 19-39: One every 3 years
  • 40-49: One every 2 years
  • 50+: Annually

Cervical Cancer Screening / HPV screening

  • 21-65: One every 3 years

Screening Mammogram

  • 57-74: One every 2 years
  • 40-50: One baseline between the ages of 40 – 50

Colorectal Cancer Screening

  • Colonoscopy every 10 years or
  • Flexible Sigmoidoscopy every 5 years or
  • FOBT/FIT annually
  • Cologuard screening every 3 years

Complete appropriate Chronic Condition Activities

Asthma, Coronary Artery Disease (CAD), Coronary Artery Disease (CAD), Chronic Obstructive Pulmonary Disease (COPD), Heart Disease/ Heart Failure, Hypertension, Diabetes (Type 1 or 2)

Member will receive 1 entry any time they complete each activity (yearly).

  • Completing member goals (factsheet or survey in Wellness Portal), or engage in on-going case management)
  • Physician visit for chronic condition management (claims based)

Notes:

If the member has multiple conditions, the member would be eligible to earn additional drawing entries for each requirement completed.

Example: Jeff has asthma. In May 2019, he agrees to participate in Case Management. He will earn an entry beginning in May 2019, and for each month until the end of the calendar year. He also goes for a Physician visit for his Asthma in June 2019. The claim is processed in August. He will earn an additional entry beginning in June 2019 (and for each month until the end of the year) for going to the doctor his asthma.

Dedicated Gold Line Service

Call our Gold Line, 833-CNY-GOLD (833-269-4653) (TTY: 711), where our specially trained Gold Line agents will make it easier for you to get your questions answered, and get the care you need more quickly.

Gift Card Rewards Program

Reinvest in yourself and earn rewards for making smart choices about where you get your care. Sign up to Go Paperless on the Member Portal to become eligible.

If you use one of our Centers of Excellence, you are eligible to receive a $100 gift card. And by having certain health care services in a doctor’s office, or outside the hospital in an ambulatory surgery setting, such as an infusion center, you could receive a gift card with a value of $50-$100.

Gift cards can be used for a range of products and resources that promote your daily and long-term health—cookbooks, vitamins, and thousands of other healthy essentials that can make you feel like your best self.

See the types of services and settings you can use to earn a gift card below. One gift card is given per episode of care. An episode of care is all of the care needed to treat a condition. Knee pain that results in a knee replacement would be one episode of care. It would result in a single gift card. Also, longer term care, such as cancer treatment, would result in a single gift card.

Gift cards may arrive about 90 days or more after you receive the service outlined below, but only if you sign in to your member portal, opt into Go Paperless For All Options, and provide your email address. If you don’t have access to email, contact a Gold Line agent about how to participate.

Gift Card Rewards Program *
For having the services below in these sites:

Service Site and gift card amount
Colonoscopy / Endoscopy
Cataracts
Arthroscopy
Free-standing
Ambulatory surgery center – $50
Doctor office – $100

 

Service at Gift card amount
Hospital for Special Surgery (HSS) for orthopedics $100
Memorial Sloan Kettering Cancer Center for oncology $100


* Subject to approval by the New York State Department of Financial Services. Participation limited to primary insured and spouse.

As an HMO Preferred member, am I automatically enrolled in Gift Cards Rewards Program?

To be eligible for the program, you must opt into EmblemHealth’s “Go Paperless” on the Member Portal.

How do I make an appointment at one of EmblemHealth’s Centers of Excellence or designated care sites to qualify for the Rewards Program?

HMO Preferred Members can call our Gold Line at 833-CNY-GOLD (833-269-4653) (TTY: 711) to speak with a Gold Line agent and get information on making an appointment at these designated care centers.

How do I redeem my gift card?

Gift cards will be emailed to members between approximately 90 and 120 days after the claim is received for your specific treatment or service at one of the designated care sites or Centers of Excellence.

Is my gift card only good for certain health products?

Gift cards can be used on range of products to support members’ health needs.

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