Silver Bold (with Family Dental and Vision)

Who's eligible: Individuals and families living within the 8 down-state New York counties. Children and young adults can stay on a parent’s plan until age 26. 

Financial assistance: Tax credits available for qualified individuals to help with premiums and out-of-pocket costs when enrolling on the NY State of Health Marketplace.


Benefits Summary

Referralsinfo Required for specialist visits
Deductibleinfo $6,500 individual/$13,000 family
Out-of-pocket maximuminfo $6,500 individual/$13,000 family
Out-of-networkinfo coverage No coverage for non-emergency services
Primary care physicianinfo 3 free sick visits then $50 before deductible                    
Preventive carenfo Fully covered
Specialist $70 before deductible
Urgent care $75 before deductible
Pharmacy               $15 generic drugs before deductible
Telemedicineinfo                Fully covered
Acupuncture                  Fully covered
Gym            Reimbursement up to $400 per calendar year if qualified
Dental               Adult and pediatric dental care
Vision               Adult and pediatric vision benefits

Provider Network

The Silver Bold plan is on EmblemHealth’s Millennium Network. Members are responsible for the total cost of non-emergency care they receive outside their plan’s provider network. 


Plan Documents

Cost Calculator

Since our Individual/Family and Essential Plans offer network-only coverage, members are responsible for the total cost of non-emergency care they receive outside their plan’s provider network.


Use the FAIR Health Calculator* to estimate the cost of non-emergency medical services and procedures by zip code.


*FAIR Health, Inc. is an independent nonprofit organization that uses actual provider charges when calculating fees. FAIR Health ensures that its fee information is accurate and complete. Please review the privacy policy and terms and conditions posted on the FAIR Health website.

*The letter ""D"" after a plan name indicates that the plan is available directly from EmblemHealth, rather than through the NY State of Health Marketplace.