PARTCRX

Plan Summary

Insurance Type
Medicare Advantage Plan (Part C w/ RX)
Insurance Provider
EmblemHealth
CMS Rating
Plan Type
HMO
Annual Deductible
$0.00

What To Know About This Plan

  • This plan has health and drug coverage

Cost Sharing Information

Prescription Drug Copay/Coninsurance Details - Initial Coverage Limit

30 Day SupplyPreferred Retail PharmaciesNon-Preferred Retail PharmaciesMail-Order Pharmacies
Tier 1: Preferred Generic$2 copay$2 copay$2 copay
Tier 2: Non-Preferred Generic$10 copay$10 copay$10 copay
Tier 3: Preferred Brand Name$35 copay$35 copay$35 copay
Tier 4: Non-Preferred Brand Name$95 copay$95 copay$95 copay
Tier 5: Specialty Tier25% coinsurance25% coinsurance25% coinsurance
90 Day SupplyPreferred Retail PharmaciesNon-Preferred Retail PharmaciesMail-Order Pharmacies
Tier 1: Preferred Generic$6 copay$6 copay$6 copay
Tier 2: Non-Preferred Generic$30 copay$30 copay$30 copay
Tier 3: Preferred Brand Name$105 copay$105 copay$105 copay
Tier 4: Non-Preferred Brand Name$285 copay$285 copay$285 copay
Tier 5: Specialty Tier25% coinsurance25% coinsurance25% coinsurance

CMS Ratings

Staying healthy - screenings, tests and vaccines

Breast cancer screening
Not Rated
Colorectal cancer screening
Cholesterol screening for patients with heart disease
Glaucoma testing
Annual flu vaccine
Pneumonia vaccine
Improving or maintaining physical health
Improving or maintaining mental health
Monitoring physical ability
Access to primary care doctor visits
Adult BMI assessment

Managing Chronic Conditions

Care for older adults – medication review
Care for older adults – functional status assessment
Care for older adults – Pain screening
Osteoporosis management in women who had a fracture
Diabetes care – eye exam
Diabetes care – kidney disease monitoring
Diabetes care – blood sugar controlled
Diabetes care – cholesterol controlled
Controlling blood pressure
Rheumatoid arthritis management
Improving bladder control
Reducing the risk of falling
Plan all-cause readmissions

Ratings of Plan Responsiveness and Care

Getting needed care
Getting appointments and care quickly
Customer service
Overall rating of health care quality
Overall rating of plan

Member Complaints, Problems Getting Services, and Choosing to Leave the Plan

Complaints about the health plan
Beneficiary access and performance problems
Members choosing to leave the plan
Plan makes timely decision about appeals
Reviewing appeals decisions
Call center – foreign language interpreter and TTY/TDD availability

Physician Finder

Physicians that accept EmblemHealth Essential (HMO) for New York

/
KEROLLE, HAROLD
1050 OCEAN AVE
BROOKLYN, NY 11226
LEWIN, JONATHAN
1414 NEWKIRK AVE
BROOKLYN, NY 11226
SMITH, AGGIE
5925 15TH AVE
BROOKLYN, NY 11219
PERVEZ, RAHILA
29 NEWKIRK PLZ
BROOKLYN, NY 11226
LIVERPOOL, STEVEN
322 LINDEN BLVD
BROOKLYN, NY 11226
MAYLOR, DAPHNEY
871 OCEAN AVE
BROOKLYN, NY 11226
SMITH, ALFORD
322 LINDEN BLVD APT A1
BROOKLYN, NY 11226
SY, ANTONIO
1812 CHURCH AVE
BROOKLYN, NY 11226
NOEL, YVONNE
5925 15TH AVE
BROOKLYN, NY 11219
BIRNBAUM, STUART
1818 NEWKIRK AVE
BROOKLYN, NY 11226
BOAH, AKUA
145 E 18TH ST
BROOKLYN, NY 11226
SOFER, DAVID
1818 NEWKIRK AVE
BROOKLYN, NY 11226
SOTNIK, REGINA
2146 BEVERLY ROAD
BROOKLYN, NY 11226
WILLEKES, KAIA
67 SAINT PAULS PL
BROOKLYN, NY 11226
PETROV, MANANA
353 OCEAN AVE
BROOKLYN, NY 11226
LEWIN, SUSAN
2146 BEVERLEY RD
BROOKLYN, NY 11226
FACTOR, KEITH
2146 BEVERLEY RD
BROOKLYN, NY 11226
PEREZ, WALTER
2146 BEVERLEY RD
BROOKLYN, NY 11226
BRIGGS, HAYDN
136 LINDEN BLVD.
BROOKLYN, NY 11226
CASIMIR, FRITZ
440 EAST 19TH STREET
BROOKLYN, NY 11226
MCINTOSH, CAROL
633 E 16TH ST
BROOKLYN, NY 11226
UTHMAN, ADEOLA
225 PARKSIDE AVE
BROOKLYN, NY 11226
LEFEVRE, MARIE EDITH
3101 CLARENDON RD
BROOKLYN, NY 11226
SCHMIDT, MARIE
2324 BEVERLY ROAD
BROOKLYN, NY 11226
CLARK, RITA
335 E 17TH ST
BROOKLYN, NY 11226
Details
HAROLD KEROLLE, M.D.
Phone Number
(718) 434-2992
Office Locations
1050 OCEAN AVE
BROOKLYN, NY 11226
1050 OCEAN AVE BROOKLYN NY, 11226

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