The information in the table below lists the Care, Place and Time to receive medical treatment. The table also includes the cost of in-network services if provided by a Preferred Provider or a non-Preferred Participating Provider, as well as emergency services.
Hover over items marked with a green dotted underline for a definition of the term.
When Enrolled with an |
||
Preferred Provider |
Non-Preferred Participating Provider |
|
Preventive Care |
$0 |
$0 |
PCP (including Mental Health Providers) |
$0 |
$10 |
Specialist Care (when referred by a PCP)* | $0 |
$10 |
Diagnostic/Lab and High-Tech Radiology | $0 |
$10 |
Physical Therapy | $0 |
$10 |
* Some services, regardless of PCP selection, have a different copay level, such as emergency, ambulatory surgery and hospital care.
EMERGENCY SERVICES | |
Urgent Care Center | $0/$10 (depending on PCP copay) |
Emergency Room | $50 |
Scheduling - Some doctors appointments may be scheduled online using ZocDoc |
ADDITIONAL INFORMATION |
Member ID Cards |
Preferred PCP Non-Preferred PCP |
If you have any questions about your new HIP HMO Preferred plan, please call Emblem Health Customer Service at 1-800-447-8255, Monday to Friday, 8 am to 6 pm. If you have a hearing or speech impairment and use a TTY/TDD, please call 711. Or, visit emblemhealth.com/city.
View the HIP HMO Notification Letter
View a list of HIP HMO Preferred Providers
Glossary of Terms