Preventive Care

Visit emblemhealth.com/city for a full list of preventive services.

PCP (including Mental Health Providers)

View a list of GHI PPO Providers

Specialist Care

Preventive Prescriptions and Diabetic Medications as listed on emblemhealth.com/city. 

If you are an employee or non-Medicare eligible retiree participating in GHI-CBP/Empire BlueCross BlueShield

As previously communicated, many procedures require pre-certification. Your provider should call NYC Healthline at 1-800-521-9574 for pre-certifications including:

• In-patient Admissions
  Within 48 hours of an emergency admission

 

• Ambulatory Surgery

 

• Physical and Speech Therapy
  After the 16th visit.

View the Announcement Letter

View the List of Services Requiring Pre-Certification

MOOP refers to the maximum amount of in-network cost-sharing expenses that you will pay in each plan year for covered services/essential health benefits received from Participating Providers under the GHI/Empire BlueCross BlueShield plans combined. MOOP includes deductibles, coinsurance and copay charge amounts that you must pay for covered in-network services and any applicable riders in a calendar year.

Cost-sharing amounts attributable to services received from Non-Participating Providers generally do not count toward MOOP.

Amounts incurred for non-covered services and other non-covered expenses, such as amounts in excess of plan allowances as well as any financial penalties do not count toward MOOP. Premiums and/or premium contributions also do not count toward MOOP. The MOOP amount may change from calendar year to calendar year**.

For July 1, 2016 – December 31, 2016

For calendar years beginning January 1, 2017 – December 31, 2017** (Subject to indexing by the federal government)