EmblemHealth Bronze Plus HSA

Which groups are eligible: Small businesses with 1 to 100 full-time equivalent (FTE) employees and a primary business address in New York State.

Which employees are eligible: 
Qualifying individuals and families living in one of 28 New York counties, including the five New York City boroughs, Westchester, Long Island, and regions stretching north of Albany. Children and young adults can stay on a parent’s plan until age 26, or through age 29 for an added cost.

  • DENTAL
  • VISION
  • Generic Drugs
  • TELEMEDICINE

Benefit Summary

Referrals info Not required for specialist visits
Deductible info $7,800 individual/$15,600 family
Out-of-pocket maximuminfo $8,200 individual/$16,400 family
Out-of-networkinfo coverage  No coverage for non-emergency services
Primary care physicianinfo 50% after deductible
Preventive careinfo  Fully covered
Specialist  50% after deductible
Urgent care $100 after deductible
Pharmacy  $35 generic drugs after deductible
Telemedicine info Covered ($0 after deductible)
Gym  Reimbursement up to $400 per plan year if qualified 
Dental Pediatric dental care
Vision Pediatric vision benefits
 

Plan Documents

Cost Calculator

Use the FAIR Health Calculator* to estimate the cost of non-emergency medical services and procedures by zip code.

 

*FAIR Health, Inc. is an independent nonprofit organization that uses actual provider charges when calculating fees. FAIR Health ensures that its fee information is accurate and complete. Please review the privacy policy and terms and conditions posted on the FAIR Health website.

Provider Network

With our robust network of quality doctors, you can get care from many of the region’s leading doctors, clinicians and facilities, including hospitals and urgent care centers.