EmblemHealth Individual Products Available For Sale

EmblemHealth's Platinum, Gold, Silver and Bronze individual plans all offer the same high-quality benefits, but the metal level you choose affects how much your premium will cost each month and what portion of the bill you pay (out-of-pocket costs).   Most plans have a deductible.  The deductible is the amount of eligible cost you must pay during a calendar year before EmblemHealth begins paying for any covered services with the exception of preventive care.

Our off-exchange plans are available for purchase directly through EmblemHealth. The on-exchange plans are offered through the NY State of Health Marketplace. Take a look at the plans below to find one that best meets your individual health care needs and budget.

Off-Exchange

HMO Products

Select Care Platinum D is an HMO plan with no annual deductible and low out-of-pocket costs.

EmblemHealth HMO Direct Payment Plans Brochure

Shop and enroll in an EmblemHealth plan

The EmblemHealth Select Care Platinum D Plan is underwritten by HIP Health Plan of New York and provides in-network benefits only. A excepción de los cuidados hospitalarios de emergencia, ningún servicio fuera de la red está cubierto. Coverage is limited to all terms, conditions, limitations and exclusions set forth in the contract. Refer to HIP policy form number 155-23-IOFFHIXCONT (04/15)

Select Care Gold D is an HMO plan with the second-lowest cost-sharing of the Select Care metal plans. The plan has a low annual deductible and reasonable out-of-pocket costs.

EmblemHealth HMO Direct Payment Plans Brochure

Shop and enroll in an EmblemHealth plan.

The EmblemHealth Select Care Gold D Plan is underwritten by HIP Health Plan of New York and provides in-network benefits only. A excepción de los cuidados hospitalarios de emergencia, ningún servicio fuera de la red está cubierto. Coverage is limited to all terms, conditions, limitations and exclusions set forth in the contract. Refer to HIP policy form number 155-23-IOFFHIXCONT (04/15)

Select Care Silver D is an HMO plan and has a reasonable deductible and copay for services associated with the costs of your care.

EmblemHealth HMO Direct Payment Plans Brochure

Shop and enroll in an EmblemHealth plan.

The EmblemHealth Select Care Silver D Plan is underwritten by HIP Health Plan of New York and provides in-network benefits only. A excepción de los cuidados hospitalarios de emergencia, ningún servicio fuera de la red está cubierto. Coverage is limited to all terms, conditions, limitations and exclusions set forth in the contract. Refer to HIP policy form number 155-23-IOFFHIXCONT (04/15)

Select Care Bronze D is an HMO plan that pays for 50% of covered health benefits after you meet an annual deductible.

EmblemHealth HMO Direct Payment Plans Brochure

Shop and enroll in an EmblemHealth plan.

The EmblemHealth Select Care Bronze D Plan is underwritten by HIP Health Plan of New York and provides in-network benefits only. A excepción de los cuidados hospitalarios de emergencia, ningún servicio fuera de la red está cubierto. Coverage is limited to all terms, conditions, limitations and exclusions set forth in the contract. Refer to HIP policy form number 155-23-IOFFHIXCONT (04/15)

Off-Exchange

EPO Products

EPO HD Platinum is an EPO (in-network coverage only) plan that allows you to spend less on cost sharing when you receive covered medical care. You must meet a low annual deductible before the plan will start paying for covered services, but once the annual deductible is met you will not be charged any additional out-of-pocket costs for covered medical services. Upon reaching your annual out-of-pocket maximum, all of your covered benefits will be paid in full by EmblemHealth for the rest of the year.

Other plan features:

  • This is an EPO plan with in-network benefits only, with access to the EPO2 network.
  • No Primary Care Physician (PCP) is required, and no referrals are needed to see a doctor.
  • Your benefits include comprehensive medical, hospital, and prescription drug coverage, which are subject to the plan deductible and other applicable cost-sharing.
  • There is no cost sharing for certain in-network preventive care services. These services are covered in full and do not count toward the deductible.

EmblemHealth EPO Direct Payment Plans Brochure

Fill out an application

Ayúdeme a elegir un plan

The EmblemHealth EPO HD Platinum Plan is underwritten by Group Health Incorporated ("GHI") and provides in-network benefits only. A excepción de los cuidados hospitalarios de emergencia, ningún servicio fuera de la red está cubierto. Coverage is limited to all terms, conditions, limitations and exclusions set forth in the contract. Refer to GHI policy form number DPC-OX-102 (01/16)

EPO HD Gold is an EPO (in-network coverage only) plan with an annual deductible and low cost sharing (coinsurance) for covered services. With this plan, you pay a bit more in premiums to lower your out-of pocket costs throughout the year. Once you meet the annual deductible, you will be responsible for coinsurance associated with your covered medical care. Upon reaching your annual out-of-pocket maximum, all of your covered benefits will be paid in full by EmblemHealth for the rest of the year.

Other plan features:

  • This is an EPO plan with in-network benefits only, with access to the EPO2 network.
  • This is a high deductible plan that may be used with an HSA to gain tax savings.
  • No Primary Care Physician (PCP) is required, and no referrals are needed to see a doctor.
  • Your benefits include comprehensive medical, hospital, and prescription drug coverage, which are subject to the plan deductible and other applicable cost-sharing.
  • No cost sharing for certain in-network preventive care services. These services are covered in full and do not count toward the deductible.

EmblemHealth EPO Direct Payment Plans Brochure

Fill out an application

Ayúdeme a elegir un plan

The EmblemHealth EPO HD Gold Plan is underwritten by Group Health Incorporated ("GHI") and provides in-network benefits only. A excepción de los cuidados hospitalarios de emergencia, ningún servicio fuera de la red está cubierto. Coverage is limited to all terms, conditions, limitations and exclusions set forth in the contract. Refer to GHI policy form number DPC-OX-102 (01/16)

EPO HD Silver is an EPO (in-network coverage only) plan with lower premiums that requires you to pay an annual deductible before the plan will start paying for covered medical services. Once you meet the annual deductible, you will be responsible for coinsurance associated with your medical care. Upon reaching your annual out-of-pocket maximum, all of your covered benefits will be paid in full by EmblemHealth for the rest of the year.

Other plan features:

  • This is an EPO plan with in-network benefits only, with access to the EPO2 network.
  • This is a high deductible plan that may be used with an HSA to gain tax savings.
  • No Primary Care Physician (PCP) is required, and no referrals are needed to see a doctor.
  • Your benefits include comprehensive medical, hospital, and prescription drug coverage, which are subject to the plan deductible and other applicable cost-sharing.
  • There is no cost sharing for certain in-network preventive care services. These services are covered in full and do not count toward the deductible.

EmblemHealth EPO Direct Payment Plans Brochure

Fill out an application

Ayúdeme a elegir un plan

The EmblemHealth EPO HD Silver Plan is underwritten by Group Health Incorporated ("GHI") and provides in-network benefits only. A excepción de los cuidados hospitalarios de emergencia, ningún servicio fuera de la red está cubierto. Coverage is limited to all terms, conditions, limitations and exclusions set forth in the contract. Refer to GHI policy form number DPC-OX-102 (01/16)

EPO HD Bronze is an EPO (in-network coverage only) plan that offers a low monthly premium and requires no cost sharing after you meet the annual deductible. Once you meet the annual deductible, you will not be charged any additional cost sharing when you receive covered medical care. Upon reaching your annual out-of-pocket maximum, all of your covered benefits will be paid in full by EmblemHealth for the rest of the year.

Other plan features:

  • This is an EPO plan with in-network benefits only, with access to the EPO2 network.
  • This is a high deductible plan that may be used with an HSA to gain tax savings.
  • No Primary Care Physician (PCP) is required, and no referrals are needed to see a doctor.
  • Your benefits include comprehensive medical, hospital, and prescription drug coverage, all of which are subject to the plan deductible and other applicable cost-sharing.
  • There is no cost sharing for certain in-network preventive care services. These services do not count toward the deductible.

EmblemHealth EPO Direct Payment Plans Brochure

Fill out an application

Ayúdeme a elegir un plan

The EmblemHealth EPO HD Bronze Plan is underwritten by Group Health Incorporated ("GHI") and provides in-network benefits only. A excepción de los cuidados hospitalarios de emergencia, ningún servicio fuera de la red está cubierto. Coverage is limited to all terms, conditions, limitations and exclusions set forth in the contract. Refer to GHI policy form number DPC-OX-102 (01/16)

On-Exchange

HMO Products

Select Care Platinum es un plan HMO sin deducible anual y desembolsos bajos.

Learn more about this plan which is offered on the NY State of Health Marketplace.

The EmblemHealth Select Care Platinum Plan is underwritten by HIP Health Plan of New York and provides in-network benefits only. A excepción de los cuidados hospitalarios de emergencia, ningún servicio fuera de la red está cubierto. Coverage is limited to all terms, conditions, limitations and exclusions set forth in the contract. Refer to HIP policy form number 155-23-IONHIXHMO (04/15)

Select Care Gold es un plan HMO con el segundo gasto compartido más bajo de los planes "metal" Select Care. The plan has a low annual deductible and reasonable out-of-pocket costs.

Learn more about this plan which is offered on the NY State of Health Marketplace.

The EmblemHealth Select Care Gold Plan is underwritten by HIP Health Plan of New York and provides in-network benefits only. A excepción de los cuidados hospitalarios de emergencia, ningún servicio fuera de la red está cubierto. Coverage is limited to all terms, conditions, limitations and exclusions set forth in the contract. Refer to HIP policy form number 155-23-IONHIXHMO (04/15)

Select Care Silver is an HMO plan that offers eligible individuals lower monthly premiums and higher out-of-pocket costs. Just like the other metal plans, people may be eligible for tax credits. It is the most popular of the metal plans.

Learn more about this plan which is offered on the NY State of Health Marketplace.

The EmblemHealth Select Care Silver Plan is underwritten by HIP Health Plan of New York and provides in-network benefits only. A excepción de los cuidados hospitalarios de emergencia, ningún servicio fuera de la red está cubierto. Coverage is limited to all terms, conditions, limitations and exclusions set forth in the contract. Refer to HIP policy form number 155-23-IONHIXHMO (04/15)

Select Care Bronze es un plan HMO que paga el 50% de los beneficios de salud cubiertos después de cumplir con su deducible anual.

Learn more about this plan which is offered on the NY State of Health Marketplace.

The EmblemHealth Select Care Bronze Plan is underwritten by HIP Health Plan of New York and provides in-network benefits only. A excepción de los cuidados hospitalarios de emergencia, ningún servicio fuera de la red está cubierto. Coverage is limited to all terms, conditions, limitations and exclusions set forth in the contract. Refer to HIP policy form number 155-23-IONHIXHMO (04/15)

Select Care Basic is a "catastrophic" HMO plan for people who are less than 30 years of age or for certain people who have a specific hardship. After reaching your annual deductible, there are no out-of-pocket costs for covered services for the rest of the year. Select Care Basic is designed for people who don't need health care services very often, but want to be protected against high costs for an unexpected accident or illness.

Learn more about this plan which is offered on the NY State of Health Marketplace.

The EmblemHealth Select Care Basic Plan is underwritten by HIP Health Plan of New York and provides in-network benefits only. A excepción de los cuidados hospitalarios de emergencia, ningún servicio fuera de la red está cubierto. Coverage is limited to all terms, conditions, limitations and exclusions set forth in the contract. Refer to HIP policy form number 155-23-IONHIXHMO (04/15)