EmblemHealth Essential (HMO)

Medicare Advantage Plan (Part C w/ RX)

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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
  • This plan is available for 2015. see plan

Why We Like This Plan

  • has both Health and Drug Coverage
  • has no additional premium costs outside of your Medicare Part B premium

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

/
LIVERPOOL, STEVEN
322 LINDEN BLVD
BROOKLYN, NY 11226
SY, ANTONIO
1812 CHURCH AVE
BROOKLYN, NY 11226
BIRNBAUM, STUART
1818 NEWKIRK AVE
BROOKLYN, NY 11226
SOFER, DAVID
1818 NEWKIRK AVE
BROOKLYN, NY 11226
WILLEKES, KAIA
67 SAINT PAULS PL
BROOKLYN, NY 11226
CASIMIR, FRITZ
440 EAST 19TH STREET
BROOKLYN, NY 11226
MCINTOSH, CAROL
633 E 16TH ST
BROOKLYN, NY 11226
LEFEVRE, MARIE EDITH
3101 CLARENDON RD
BROOKLYN, NY 11226
CLARK, RITA
335 E 17TH ST
BROOKLYN, NY 11226
CLARK, JULIAN
335 E 17TH ST
BROOKLYN, NY 11226
GEIGER, ARTHUR
1818 NEWKIRK AVE
BROOKLYN, NY 11226
LEFEVRE, LIONEL
3101 CLARENDON RD
BROOKLYN, NY 11226
DESAI, RAJESH
1095 FLATBUSH AVE
BROOKLYN, NY 11226
MOHAMED, SALAHELDIN
2848 CHURCH AVE
BROOKLYN, NY 11226
CONDE, MARIE
350 OCEAN AVE
BROOKLYN, NY 11226
OSEI-TUTU, PRUDENCE
84 LINDEN BLVD
BROOKLYN, NY 11226
FAMILY CARE CENTER
941 OCEAN AVE
BROOKLYN, NY 11226
VITAL, LOUIS
3223 CHURCH AVENUE
BROOKLYN, NY 11226
GARNER, HOPE
187 MARLBOROUGH RD
BROOKLYN, NY 11226
MEDWYNTER, CHARLES
2802 ALBEMARLE RD FL 3
BROOKLYN, NY 11226
GALLAGHER, MINDY
540 E NEW YORK AVE
BROOKLYN, NY 11225
MCMILLAN, GEORGE
614 EASTERN PKWY
BROOKLYN, NY 11225
BOYCE, ROGER
1821 BEDFORD AVE
BROOKLYN, NY 11225
ACENAS-RECIENTES, ELIZABETH
546 EASTERN PARKWAY
BROOKLYN, NY 11225
BUCOBO, YOLEIDA
546 EASTERN PARKWAY
BROOKLYN, NY 11225
Details
STEVEN LIVERPOOL, M.D.
Phone Number
(718) 282-1570
Office Locations
322 LINDEN BLVD
BROOKLYN, NY 11226
322 LINDEN BLVD BROOKLYN NY, 11226

Community Q&A

Do you have questions about this plan?

Get answers from the HealthPocket community.
1 question
Dentists
Q:do you have a listing of dentists in Manhattan, NYC?
Asked by Morales 
Know the Answer? Answer this Question

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