Business Details
50+ Years
experience
Your Trusted Health Insurance Partner in New York City
Emblem Health stands as one of the nation's largest not-for-profit health insurers, dedicated to improving the health and well-being of New Yorkers for over 85 years. Our organization reinvests in members and communities, offering affordable coverage through products like the $0 premium Essential Plan, which provides access to a vast provider network with no referrals required. We specialize in personalized care through AdvantageCare Physicians, a primary and specialty care practice serving over half a million patients across New York City and Long Island. Our commitment to quality over quantity is demonstrated by partnerships with top institutions like Memorial Sloan Kettering Cancer Center and Hospital for Special Surgery. Through Neighborhood Care locations, we provide free wellness classes and community resources, while our 24/7 Nurse Line supports members with immediate health guidance.With expertise in Medicare Advantage, Medicaid Managed Care, and specialty network development, we prioritize accessible, comprehensive healthcare solutions. Our authority in the industry is reinforced by decades of experience, innovative pharmacy cost management programs, and a focus on preventive care that addresses both physical and mental health factors. Transparency is maintained through accessible plan documents, online member portals, and clear communication channels. Our trustworthiness is built on non-profit status, community reinvestment, and a track record of adapting to evolving healthcare needs while maintaining affordability.
Services
Health Insurance Plans
Medicare Advantage
Medicaid Managed Care
Essential Plan
Telehealth Services
Primary Care
Specialty Care
Free Wellness Classes
Pharmacy Management
Care Navigation
Details
- Year established: 1938
Highlights and features
- We have 85 years of experience providing healthcare solutions in New York
- Our non-profit status ensures reinvestment into member benefits and communities
- Network includes top institutions like Memorial Sloan Kettering Cancer Center
- We offer $0 premium coverage options through government-sponsored programs
- 24/7 Nurse Line provides immediate medical guidance for all members
What people say
$0 premium options
Extensive provider network
Free wellness programs
Specialty care access
Local community focus
Services
Health Insurance Plans
We offer comprehensive health insurance solutions including Medicare Advantage, Medicaid Managed Care, and individual/family plans with $0 premiums for eligible members. Our plans provide access to extensive provider networks, prescription drug coverage, and specialized healthcare services. With no referrals required to see specialists, our members receive timely, coordinated care across New York State.
Neighborhood Care
Our Neighborhood Care locations provide free wellness classes, health screenings, and community resources. These accessible centers help members address health barriers, develop healthy habits, and connect with local support services. Staffed by community-based care navigators who understand local healthcare challenges, this service promotes preventative care and healthy lifestyle choices.
24/7 Nurse Line
Available to all members, our Nurse Line staffed by trained professionals offers medical guidance day and night. Nurses help assess symptoms, provide treatment advice, and direct members to appropriate care facilities. This service ensures immediate assistance for urgent health concerns while helping prevent unnecessary emergency room visits.
AdvantageCare Physicians
As part of our network, AdvantageCare Physicians delivers personalized primary and specialty care to over half a million patients. Their whole-person approach considers physical, mental, and lifestyle factors to create individualized care plans. With locations across NYC and Long Island, they offer convenient access to comprehensive medical services including chronic disease management and preventive care.
Pharmacy Management
Our pharmacy management program helps control medication costs through strategic drug formulary development and price negotiations. The program includes medication therapy management for complex prescriptions and a convenient home delivery service. Members benefit from lower out-of-pocket expenses while maintaining access to necessary medications through our extensive pharmacy network.
Questions
What health insurance plans do you offer?
We offer Medicare Advantage, Medicaid Managed Care, Essential Plan with $0 premiums for eligible members, and Qualified Health Plans for individuals and families across New York State.
Are the $0 premium plans really free?
Yes, our Essential Plan offers $0 monthly premiums for adults aged 19-64 who meet income requirements, with full access to our provider network and specialist care.
How can I find a doctor in your network?
Use our online provider directory or call 888-225-6133 to connect with Neighborhood Care specialists who can help you find an in-network doctor or AdvantageCare Physicians location near you.
Do you offer emergency medical services?
While we don't provide direct emergency services, our plans cover emergency care at network hospitals across New York State and nationwide through Medicare coverage.
What wellness services are available?
We offer free health and fitness classes through Neighborhood Care locations, plus chronic condition management programs and 24/7 Nurse Line medical guidance for all members.
How do I get prescription coverage?
All our plans include pharmacy benefits with access to our network of pharmacies, home delivery service, and medication therapy management for complex prescriptions.
Reviews (4)
Sa Ahmed
Apr 09, 2022
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This advantage care health center is very clean and bright. Some d decoration in outside of the entrance and a wide big floor for front desh or welcome desk. This building is a huge business place and has other business inside, like Chase Bank, Airforce. Roadside parking is not suggested because there is a chance to get parking violation summon.
Trish Mccormick
Feb 17, 2021
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Critical: Professionalism, Responsiveness A TOTAL DISGRACE! BEEN CALLING SINCE NOVEMBER OF 2020 TO GET PAYMENTS REISSUED SINCE EMBLEM SENT THEM TO WRONG ADDRESS. FIVE MONTHS OF DISCONNECTED CALLS AND LIES. THEY SHOULD BE SHUT DOWN. WORST REPS IN ANY BUSINESS. THEY HAVE NO KNOWLEDGE OF INSURANCE, CLAIMS, OR ANYTHING. REPORTING TO THE FEDERAL TRADE COMMISSION.
Eva Rojas
Nov 14, 2020
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After seeing the heavy advertising suggesting that " normal" is not okay and that everyone wearing masks is okay. It is more than clear that you are in the business of keeping people sick and are taking advantage of the pandemic to profit. I would never consider Emblem Health as a medical insurance after seeing this company spending so much money on sick advertising, which if undone, would make the price of health insurance much cheaper. This adverts you are running take away from my experience of being a healthy human being.
Susan Kachura
Jun 09, 2020
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I'm on medicare and just switched to Emblem for supplementary. It is the WORST experience. Customer service promise call backs that never come, problems never resolved and their customer service reps have NO knowledge of the insurance business and have no clue how to help. I have been trying to resolve an issue for 2 months and hours on the phone. Still not resolved.
