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2025 Summary of Benefits

 

2025 Enrollment Applications

  • 2025 EmblemHealth Medicare Advantage (HMO) Enrollment Form for all VIP Plans except EmblemHealth VIP Dual plans

  • 2025 EmblemHealth Medicare Advantage Enrollment form for EmblemHealth VIP Dual (HMO D-SNP) and EmblemHealth VIP Dual Reserve (HMO D-SNP)
 

2025 Sales Brochures

 

2025 Plan Related Form and Helpful Links

 

2025 Provider and Dental Directories

  • Medicare HMO Provider Directory - VIP Bold Network - Bronx

  • Medicare HMO Provider Directory - VIP Bold Network - Kings (Brooklyn)

  • Medicare HMO Provider Directory - VIP Bold Network - Nassau

  • Medicare HMO Provider Directory - VIP Bold Network - New York

  • Medicare HMO Provider Directory - VIP Bold Network - Queens

  • Medicare HMO Provider Directory - VIP Bold Network - Richmond (Staten Island)

  • Medicare HMO Provider Directory - VIP Bold Network - Suffolk

  • Medicare HMO Provider Directory - VIP Bold Network - Capital Region (Albany, Broome, Columbia, Delaware, Greene, Rensselaer, Saratoga, Schenectady, Warren and Washington)

  • Medicare HMO Provider Directory - VIP Bold Network - Hudson Valley (Dutchess, Orange, Rockland, Putnam, Sullivan, Ulster and Westchester)

  • Medicare HMO Provider Directory - VIP Reserve Network - Bronx and New York

  • Medicare HMO Provider Directory - VIP Reserve Network - Kings (Brooklyn) and Queens

  • Dental Directory

 

2025 Pharmacy Directory and Formularies

  • Medicare Preferred Performance Pharmacy

    (VIP Rx Saver (HMO), VIP Gold (HMO), VIP Gold Plus (HMO), and VIP Reserve (HMO) plans)

  • National Medicare Performance Pharmacy Directory

    (VIP Dual (HMO D-SNP), VIP Dual Reserve (HMO D-SNP), and VIP Dual Enhanced (HMO D-SNP)plans

  • EmblemHealth 6-Tier Non D-SNP Medicare Advantage Drug Formulary

  • EmblemHealth D-SNP Medicare Advantage Formulary