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Emblemhealth Overview

EmblemHealth is one of the nation’s largest not-for-profit health insurers, serving more than three million people in New York City and the tristate area. For the past 80 years, EmblemHealth has been taking care of New York’s heart and soul, its people. Today, healthcare is more complex than ever. That’s why EmblemHealth remains committed to finding new ways to deliver quality care at affordable prices.

EmblemHealth Medical Plans

Network availability & ELIGIBILITY

EMBLEMHEALTH

NEW YORK

NEW JERSEY

CONNECTICUT

NATIONWIDE
To enroll in Prime plans employees must live/work/reside in NY, NJ and CT. Prime PPO and Prime Gold Virtual members have access to the First Health National Network and can reside in any of the 50 US states. Prime Prime -
QualCare		 Prime -
 ConnectiCare		 First Health
(PPO & Gold Virtual plans only)
To enroll in Select Care plans employees must live/work/reside in NY. Select Care N/A N/A N/A
To enroll in Millennium plans employees must live/work/reside in the five boroughs, Nassau, Suffolk and Westchester. Millennium N/A N/A N/A

Pediatric Dental

EMBLEMHEALTH

NEW YORK

NEW JERSEY

CONNECTICUT

NATIONWIDE
EmblemHealth DentaQuest DentaQuest DentaQuest N/A

Pediatric Vision

EMBLEMHEALTH

NEW YORK

NEW JERSEY

CONNECTICUT

NATIONWIDE
EmblemHealth EyeMed EyeMed EyeMed EyeMed
Telemedicine
  • When a member uses their Teladoc services there is no charge excluding HSA plans where a $45 copay applies prior to the deductible. AdvantageCare Physicians Centers are also available to schedule virtual visits. Virtual plan members have access to ACPNY via the EmblemHealth app. Medly Pharmacy medication delivery service is available at no cost.
Prescription Mail Order
  • When a member uses Express Scripts to order a 90-day supply of a drug they will pay 2.5 months of copays. Register on-line at https://www.express-scripts.com
Added Values
  • Gym reimbursement - 50 visits per a 6-month period and earn up to $200. The covered spouse earns $100 per 50 visits within a 6-month period.
  • Acupuncture is a covered benefit excluding Millennium plans.
  • Adult dental and vision coverage - included in the Prime Silver, Select Care Silver, Prime Bronze and Select Care Bronze plans. (Pediatric dental and vision are included in all plans.)

Provider Directory

  • 1. Select "Find a Doctor"
  • 2. Select "Small Group Plans"
  • 3. Select a plan
  • 4. Enter requested information and search
Take Me To The Provider Website

Healthfirst OVERVIEW

For more than 25 years, Healthfirst has been serving New Yorkers. Healthfirst helped pioneer the value-based healthcare model—where hospitals and physicians are paid based on patient outcomes—because Healthfirst was founded on the belief that insurers need to be true partners in the health system.

Healthfirst Medical Plans

Network availability & ELIGIBILITY

Healthfirst

NEW YORK

NEW JERSEY

CONNECTICUT

NATIONWIDE
To enroll in Pro plans employees must live/work/reside in the five boroughs, Nassau and Suffolk. Healthfirst* N/A N/A N/A
*Service area consists of five boroughs, Nassau, Suffolk and certain network access in Westchester    

Pediatric Dental

Healthfirst

NEW YORK

NEW JERSEY

CONNECTICUT

NATIONWIDE
Healthfirst DentaQuest N/A N/A N/A

Pediatric Vision

Healthfirst

NEW YORK

NEW JERSEY

CONNECTICUT

NATIONWIDE
Healthfirst Davis Vision Davis Vision Davis Vision Davis Vision

 

Telemedicine
  • When a member uses their Teladoc services there is no charge excluding HSA plans where a $40 Primary/$75 Specialist copay applies prior to the deductible. Teladoc is just a click away - teladoc.com/healthfirst
  • Capsule, Medly Pharmacy and ExactCare medication delivery services, for non-maintenance medications are also available.
Prescription Mail Order
Added Values
  • Gym reimbursement - 50 visits per 6-month period and earn $200. The covered spouse will earn $100 for 50 visits within a 6-month period.
  • Acupuncture is a covered benefit.

Provider Directory

  • 1. Select "Healthfirst Platinum, Gold, Silver and Bronze Pro EPO Provider Directories"
  • 2. Enter search criteria

Take Me To The Provider Website

OSCAR OVERVIEW

Founded in 2012, Oscar was the first direct-to-consumer health insurer pairing member engagement with its own full-stack technology. Since it began serving members in 2014, they have made great progress against their mission of creating a simpler and more affordable health insurance experience for more people across the U.S.

Oscar Medical Plans

Network availability & ELIGIBILITY

Oscar

NEW YORK

NEW JERSEY

CONNECTICUT

NATIONWIDE
To enroll in Circle plans employees must live/work/reside in the five boroughs, Nassau, Suffolk, Westchester and Rockland. Circle Qualcare N/A N/A

Pediatric Dental

Oscar

NEW YORK

NEW JERSEY

CONNECTICUT

NATIONWIDE

 
Oscar           Liberty Dental Plan Liberty Dental Plan Liberty Dental Plan  Liberty Dental Plan

Pediatric Vision

Oscar

NEW YORK

NEW JERSEY

CONNECTICUT

NATIONWIDE

 
Oscar            Davis Vision Avesis Davis Vision  Davis Vision

 

Telemedicine
  • When a member uses Oscar’s Doctor on Call services there is no charge.
  • Rx renewal and Capsule Rx medication delivery is also available through Doctor on Call.
Prescription Mail Order
Added Values
  • Access to your own Concierge team of experts to help you find doctors, answer questions and more.
  • Step tracking - Track steps to earn up to $100 a year in Amazon gift cards.
  • Acupuncture is a covered benefit.

Provider Directory

  • 1. Select  "Find doctors & drugs"
  • 2. Select "Search Network"
  • 3. Enter required information to search
Take Me To The Provider Website

Oxford Overview

Oxford serves millions of people from their earliest years through their working lives and into retirement. What unites them is their mission to help people live healthier lives and make the health system work better for everyone.

Oxford is working to play their part in creating a more sustainable healthcare system: one that works better for everyone.

Oxford Medical Plans

Network availability & ELIGIBILITY

Oxford

NEW YORK

NEW JERSEY

CONNECTICUT

NATIONWIDE
To enroll in Metro plans employees must live/work in NY and NJ. Metro Metro N/A N/A
To enroll in Liberty non-gated plans employees can live anywhere in the continental US.

To enroll in Liberty gated (G) plans employees must live in NY, NJ and CT. These members have access to Choice Plus when they travel or have children attending college outside of the Oxford service area (NY/NJ/CT).		 Liberty* Liberty Liberty Choice Plus
*Service area consists of five boroughs, Nassau, Suffolk, Westchester, Rockland, Orange, Putnam, Dutchess, Ulster and Sullivan (other New York areas access Choice Plus).

Pediatric Dental

Oxford

NEW YORK

NEW JERSEY

CONNECTICUT

NATIONWIDE
Oxford National Options
PPO 20		 National Options
PPO 20		 National Options
PPO 20		 National Options
PPO 20

Pediatric Vision

Oxford

NEW YORK

NEW JERSEY

CONNECTICUT

NATIONWIDE
Oxford UnitedHealthcare
Vision/Spectera		 UnitedHealthcare
Vision/Spectera		 UnitedHealthcare
Vision/Spectera		 UnitedHealthcare
Vision/Spectera
Telemedicine

  • Oxford – 1.0 groups (those that haven’t renewed into Oxford enhancements as of 5/1/2020) due to COVID-19 can access the virtual benefit for $0 on amwell.com and use the coupon code.

  • Oxford - 2.0 groups (those that renewed 5/1/2020 and forward) have access to virtual visit benefits, via Doc On Demand, AmWell and Teladoc, on myuhc.com or through the UnitedHealthcare mobile app. Copays vary by plan.

Prescription Mail Order
  • When a member uses OptumRx to order a 90-day supply of a drug they will pay 2.5 months of copays. Register on-line at https://www.optumrx.com
Added Values
  • Gym reimbursement - 50 visits per 6-month period and earn $200. The covered spouse and eligible dependents earn $100 for 50 visits per 6-month period.

Provider Directory

  • 1. Click on your plan - You can find your plan name on the front of your member ID card in the bottom right corner
  • 2. Enter the type of medical care you are looking for or click find healthcare by category

Take Me To The Provider Website