GHI Senior Care

If you are a retiree with Medicare Parts A and B, you can enroll in our GHI Senior Care program. This plan supplements your Medicare benefits.

This plan will pay some of your Medicare costs after you paid your annual deductible. With this plan, Senior Care will cover the services below.

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Plan Details

The following is effective as of January 1, 2025.

After you meet the Medicare and plan Deductibles, the services set forth below are covered, subject to the copayment shown. The service must have been covered by Medicare to be eligible for benefits under this section. Copays are limited to one copay per provider per date of service.

  • Primary Care Physician Office Visits: $15 copayment per visit
  • Specialist Office Visit: $15 copayment per visit
  • Allergy testing/injections: $15 copayment per visit
  • X-rays: $15 copayment per visit
  • Laboratory tests: $15 copayment per test
  • Complex diagnostic and radiology services: $15 copayment per visit
  • Radiation therapy: $15 copayment per visit
  • Urgent Care Services: $15 copayment per visit
  • Emergency Care (Professional Component): $15 copayment per visit
  • Mental Health Care (Outpatient): $15 copayment per visit
  • Substance Use Disorder Services (Outpatient): $15 copayment per visit
  • Physical, Occupational, and Speech Therapy: $15 copayment per visit
  • Cardiac Rehabilitation: $15 copayment per visit
  • Pulmonary Rehabilitation: $15 copayment per visit
  • Chiropractic Care: $15 copayment per visit
  • Podiatry Care: $15 copayment per visit
  • Vision Care: $15 copayment per visit
 

Plan Documents

 

Certificate of Insurance

Your Certificate of Coverage describes the benefits available under the group contract.
Coverage for Medicare Eligible Individuals is located on pages 66 to 69 of the Certificate

  • EHPI/GHI CBP Certificate of Insurance, Base Plan

  • EHPI/GHI CBP Certificate of Insurance - Base Plan + Enhanced Rider, Less Rx

  • EPHI/GHI CBP Certificate of Insurance, Base Plan + Enhanced Rider + Rx

Provider Coverage

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.

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The Right Care, Right in Your Neighborhood

AdvantageCare Physicians are the newest addition to the EmblemHealth family and are now one of the largest primary and specialty care practices in New York City. With 37 locations throughout New York City and Long Island, you can find a convenient location near home or work.