The $15 copayment for the EmblemHealth-GHI portion of the Senior Care Plan for City of New York (CNY) retirees resumed Jan. 1, 2025. As part of the benefit plan collectively bargained between the City and its unions, Senior Care members are now required to pay a $15 copay each time they use the health services listed below. Copays are limited to one copay per provider per date of service.
If you are a provider delivering the following services for Senior Care Plan members, you will need to collect the required $15 copay:
- Primary care provider (PCP) office visits.
- Specialist office visits.
- Allergy testing/injections.
- X-rays.
- Laboratory tests.
- Complex diagnostic and radiology services.
- Radiation therapy.
- Urgent care services.
- Emergency care (professional component).
- Mental health care (outpatient).
- Substance use disorder services (outpatient).
- Physical, occupational, and speech therapy.
- Cardiac rehabilitation.
- Pulmonary rehabilitation.
- Chiropractic care.
- Podiatry care.
- Vision care.
Please note: Senior Care Plan members are responsible for the annual Medicare Part B deductible and $50 GHI Senior Care deductible.
JP 68152 01/2025