The EmblemHealth FEHB Program

Standard Option Plan

This is our in-network plan, which means you can get care from our large network of quality doctors, including specialists, without a referral. Simply choose one of our network doctors and make an appointment.

In most cases, your only out-of-pocket cost will be a copay. For dependent children under the age of 26, copays are eliminated for all office visits, including but not limited to allergies, physical and speech therapy, specialists, and laboratory and radiology services.

Enrollment: 800-624-2414 (TTY: 711) Monday to Friday, 8 a.m. to 6 p.m.

Customer Service: Call the number on your member ID card, Monday to Friday,
8 a.m. to 6 p.m.

 

Enrollment codes and rates 2022   

The Standard Option Plan serves New York City plus most New York counties, as well as northern New Jersey.


These plans are only available to individuals who live or work in certain counties. Please see Federal RI 73-007 for the counties included in the service area.

 

Type of Enrollment Enrollment Code Premium Rate
Biweekly Monthly
Gov't Share Your Share
Gov't Share Your Share

All of New York and northern New Jersey

Standard Option Self Only 804

$244.86 $235.07 $530.53 $509.32
Standard Option Self Plus One 806

$524.63 $591.71 $1,136.70 $1,282.04
Standard Option Self and Family 805

$574.13 $590.20 $1,243.95 $1,278.77

FEHB Program | EmblemHealth

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.

You can find network doctors throughout the neighborhoods of all five boroughs of New York City, plus in Nassau, Suffolk, Westchester, Rockland, and Orange counties.

With an EmblemHealth plan you have coverage at top-ranked area hospitals, including:

• Lenox Hill Hospital

• Memorial Sloan-Kettering Cancer Center

• Montefiore Medical Center

• Northwell Health

• NYU Hospital Center

• Staten Island University Hospital

• St. Barnabas Hospital Health Center

• And many more

Need to see a doctor?

To find a doctor in your plan’s network, click the "Find a Doctor" link below.

You can use the handy Map and Directions tool to locate a doctor’s office when you click on his or her name in our directory. Note that this tool is also available via smartphone!

Looking for Teladoc™ information?

 

In your secure member portal, myEmblemHealth, you have convenient access to your personal information, including benefits and valuable health management tools.

Once you're registered, you can check:

  • The status of a claim, approval, or the amount you have paid toward your deductible, if any. (A deductible is the amount you pay before your plan starts to pay.)
  • Descriptions of your health benefits.
  • Messages — You can communicate securely with us through the Message Center.
  • A list of your covered drugs.
  • You can also order member ID cards, download forms, and update your email address.

Assess and track your health

myEmblemHealth has lots of tools to help you take care of your health and meet your personal wellness goals.

  • Health Assessment: Gives you an overall picture of your health and shows you steps you can take to make healthy lifestyle changes. Both you and your covered dependents can fill out your own individual Health Assessment.
  • Health Action Plans: These personalized programs help you make healthy choices and manage your health conditions. Each Action Plan is based on your personal choices to help you change things like sleep and nutrition habits, or improve your blood pressure and cholesterol. They can last anywhere from a few days to a few weeks, depending on your unique needs.

Get your documents online

When you register for myEmblemHealth, you can go paperless by signing up to get your documents online. They will be neatly stored in your secure Message Center on myEmblemHealth.

You can choose to get the following:

  • Explanations of benefits (EOBs).
  • Alerts about when your claims are processed.
  • Personalized information about your health.
  • Your plan newsletter.
  • Updated information about your coverage and benefits.

Enrollment and customer service

If you are a prospective member and have questions about enrollment, call 877-842-3625, Monday to Friday, 8 a.m. to 6 p.m. Use the interactive voice response (IVR) system after business hours. If you have a hearing or speech impairment and use a TYY, call 711.

If you are a current plan member, call 877-842-3625 (TTY: 711), Monday to Friday, 8 a.m. to 6 p.m.

Choosing EmblemHealth FEHB

If you’d like to join an EmblemHealth FEHB plan in which you’re not currently enrolled, simply fill out the enrollment form available from your agency’s Human Resources office. Make sure to include the EmblemHealth FEHB plan enrollment codes as shown on the Enrollment Codes and Rates section.


 

2022 Plan Documents


 

2021 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.

immunizations

A partner in wellness

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.