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2024 Summary of Benefits


 

2024 Enrollment Applications

  • 2024 EmblemHealth Medicare Advantage (HMO) Enrollment Form for all VIP Plans except EmblemHealth VIP Dual plans.

  • 2024 EmblemHealth Medicare Advantage(D-SNP) Enrollment form for EmblemHealth VIP Dual (HMO D-SNP) and VIP Dual Reserve (HMO D-SNP)


 

2024 Sales Brochures


 

2024 Plan Related Form and Helpful Links


 

2024 Provider and Dental Directories

  • Medicare HMO Provider Directory - VIP Bold Network - Bronx

  • Medicare HMO Provider Directory - VIP Bold Network - Kings (Brooklyn)

  • Medicare HMO Provider Directory - VIP Bold Network - Nassau

  • Medicare HMO Provider Directory - VIP Bold Network - New York

  • Medicare HMO Provider Directory - VIP Bold Network - Queens

  • Medicare HMO Provider Directory - VIP Bold Network - Richmond (Staten Island)

  • Medicare HMO Provider Directory - VIP Bold Network - Suffolk

  • Medicare HMO Provider Directory - VIP Bold Network - Capital Region (Albany, Broome, Columbia, Delaware, Greene, Rensselaer, Saratoga, Schenectady, Warren and Washington)

  • Medicare HMO Provider Directory - VIP Bold Network - Hudson Valley (Dutchess, Orange, Rockland, Putnam, Sullivan, Ulster and Westchester)

  • Medicare HMO Provider Directory - VIP Reserve Network - Bronx and New York

  • Medicare HMO Provider Directory - VIP Reserve Network - Kings (Brooklyn) and Queens

  • Dental Directory


 

2024 Pharmacy Directory and Formularies

  • Medicare Preferred Performance Pharmacy

    (VIP Value (HMO),  VIP Rx Saver (HMO), VIP Gold (HMO), VIP Gold Plus (HMO), VIP Reserve Classic (HMO) and select VIP Premier (HMO) group plans)

  • National Medicare Performance Pharmacy Directory

    (National Drug Plan (PDP), VIP Dual (HMO D-SNP), VIP Dual Reserve (HMO D-SNP), select EmblemHealth Group Access Rx (PPO) plans, and VIP Premier (HMO) group plans

  • 2024 EmblemHealth 6-Tier Medicare Advantage Drug Formulary

Broker Sales Support Team