Find benefit summaries, formularies (list of covered drugs), and all necessary forms to get the most out of your EmblemHealth coverage.
Looking for Medicare forms and documents?
Search
Popular Tasks
Neighborhood Care
Forms and Documents
What are you looking for?
-
Health Insurance Claim Form - EmblemHealth, HIP, GHI
This form is used when seeking reimbursement for non-participating providers. -
Patient and Physician Statement Claim Form - HIP
Patient and Physician Statement Claim Form for HIP members -
Pharmacy Benefit Services Prescription Drug Claim Form - EmblemHealth
This form allows you to submit claims for EmblemHealth prescriptions. -
Authorization to Use and Disclose Protected Health Information - EmblemHealth
Authorization, Verification and Certification Forms Authorization to Use and Disclose Protected Health Information A written authorization is required for your plan to share a member's protected health information with anyone, except as required or permitted by law.
Member Handbooks
Your member handbook tells you how your plan coverage works to get the medical care you need and avoid out-of-pocket costs. Some sections of your member handbook have been updated. For information about the changes refer to the inserts at the end of the member handbook.
-
Enhanced Care (Medicaid)
-
Enhanced Care Plus (HARP)