Health Insurance
of 2024
- Get Coverage as soon as Tomorrow!
- Short term coverage is ideal if you missed enrollment, can't afford traditional insurance, are between jobs, just graduated or retired early.
- Covers: ER & hospitals coverage, Doctors, Labs, Urgent Care & More
- Visit any doctor in their nationwide network; no referral required
- No long term commitment. Budget Friendly.
EmblemHealth Health Insurance Review
EmblemHealth is a privately held company that provides affordable and quality health benefits to individuals, families, and businesses. The company delivers personalized health insurance that offer a mix of premium, coverage and out of pocket costs.
What’s Included with EmblemHealth?
- Chiropractic/physical therapy
- Behavioral health care services
- Radiology services
- Laboratory services
- Home infusion therapy
- Prescription drugs
- Maternity and newborn care
- Habilitative and rehabilitative services
- Mental health and substance abuse services
- Pediatric vision care
- Inpatient and outpatient hospital services
- Refractive and diabetic eye exams
- Special kinds of care
Types of Health Insurance Plans
|
Businesses and Organizations |
Yes |
|
Individuals and Families |
Yes |
|
Short-Term Health Insurance |
Not Stated |
Other Plans Offered:
- Catastrophic Plans
- The Essential Plan
- Medicaid
- FirstSmiles
- Child Health Plus
Plans Reviewed
Select Care Basic
- Annual deductibles: $6,850 per individual and $13,700 per family
- Out-of-pocket limit: $6,850 per individual and $13,700 per family
- For individuals under the age of 30 and others who qualifies based on their financial needs
- No co-payments and co-insurance after deductibles
- 100% coverage for preventive care that includes immunizations, screenings, routine checkups, mammogram, and prostate exam Access to AdvantageCare Physicians
Select Care Bronze
- Annual deductibles: $3,700 per individual and $7,000 per family
- Out-of-pocket limit: $6,850 per individual and $13,700 per family
- 50% co-insurance after deductibles
- No co-payment after deductibles
- Access to AdvantageCare Physicians
- 100% coverage for preventive care that includes mammogram, immunizations, colonoscopy, cervical screening, prostate exam, and routine check-ups
Select Care Silver
- Annual deductibles: $2,000 per individual and $4,000 per family
- Out-of-pocket limit: $5,500 per individual and $11,000 per family
- Co-payment after deductible: $30/$50/$150
- Co-insurance after deductibles on selected servicesAccess to AdvantageCare Physicians
- 100% coverage for preventive care services that includes immunizations, routine check-ups, mammogram, cervical screening, colonoscopy, and prostate exam
Select Care Gold
- Annual deductibles: $600 per individual and $1,200 per family
- Out-of-pocket limit: $4,000 per individual and $8,000 per family
- Co-insurance after deductibles on selected services
- 100% coverage for preventive care services that includes prostate exam, routine check-ups, immunizations, mammogram, cervical screening, and colonoscopy
- Access to AdvantageCare Physicians
Select Care Platinum
- No annual deductibles for individuals and families
- Out-of-pocket limit: $2,000 per individual and $4,000 per family
- Co-insurance after deductibles on selected services
- Co-payment after deductibles: $15/$35/$100
- 100% coverage for preventive care services that includes mammogram, colonoscopy, prostate exam, immunizations, routine check-ups, and cervical screening
- Access to AdvantageCare Physicians
How Much Does It Save You?
|
Services Offered |
Select Care Basic |
Select Care Bronze |
Select Care Silver |
Select Care Gold |
Select Care Platinum |
|
Major Cost-Sharing Provisions |
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|
Prescription Drugs |
0% co-insurance after deductible |
Generic: $10 co-pay Preferred brand: $35 co-pay Non-preferred brand: $70 co-pay Specialty drugs: $70 co-pay |
Generic: $10 co-pay Preferred brand: $35 co-pay Non-preferred brand: $70 co-pay Specialty drugs: $70 co-pay |
Generic: $10 co-pay Preferred brand: $35 co-pay Non-preferred brand: $70 co-pay Specialty drugs: $70 co-pay |
Generic: $10 co-pay Preferred brand: $30 co-pay Non-preferred brand: $60 co-pay Specialty drugs: $60 co-pay |
|
Hospital Admission |
0% co-insurance after deductible |
50% co-insurance after deductible |
$1,500 co-pay per admission after deductible |
$1,000 co-pay per admission after deductible |
$500 co-pay per admission |
|
Emergency Room Co-pay |
5% co-insurance after deductible |
50% co-insurance after deductible |
$150 co-pay per visit after deductible |
$150 co-pay per visit after deductible |
$100 co-pay per visit |
|
Primary Care Physician Office Visits |
0% co-insurance after deductible |
50% co-insurance after deductible |
$30 co-pay per visit after deductible |
$25 co-pay per visit after deductible |
$15 co-pay per visit |
|
Specialists Office Visit |
0% co-insurance after deductible |
50% co-insurance after deductible |
$50 co-pay per visit after deductible |
$40 co-pay per visit after deductible |
$35 co-pay per visit |
|
Inpatient Hospital Services |
|||||
|
Inpatient Physician and Surgical Services |
0% co-insurance after deductible |
50% co-insurance after deductible |
$100 co-pay after deductible |
$100 co-pay after deductible |
$100 co-pay |
|
Operating and Recovery Room, Lab Tests, X-rays, General Nursing Care, Intensive and Special Care, and Prescribed Drugs |
0% co-insurance after deductible |
50% co-insurance after deductible |
Included in hospital admission co-pay after deductible |
Included in hospital admission co-pay after deductible |
Included in hospital admission co-pay |
|
Pre-admission Testing |
0% co-insurance after deductible |
50% co-insurance after deductible |
Covered in full |
Covered in full |
Covered in full |
|
Short-term Speech, Occupational, Physical, and Respiratory Therapy |
5% co-insurance after deductible |
50% co-insurance after deductible |
Included in hospital admission co-pay after deductible (short-term only) |
Included in hospital admission co-pay after deductible (short-term only) |
Included in hospital admission co-pay (short-term only) |
|
Radiation Therapy and Chemotherapy |
0% co-insurance after deductible |
50% co-insurance after deductible |
Subject to PCP office visit co-pay after deductible |
Subject to PCP office visit co-pay after deductible |
Subject to PCP office visit co-pay |
|
Semi-private Room and Abroad |
0% co-insurance after deductible |
50% co-insurance after deductible |
Included in hospital admission co-pay after deductible |
Included in hospital admission co-pay after deductible |
Included in hospital admission co-pay |
|
Outpatient Hospital Services |
|||||
|
Special Office Visits |
0% co-insurance after deductible |
50% co-insurance after deductible |
Subject to specialist office visit co-pay after deduction |
Subject to specialist office visit co-pay after deductible |
Subject to specialist office visit co-pay |
|
Well-child Care |
Covered in full |
Covered in full |
Covered in full |
Covered in full |
Covered in full |
|
PCP Office Visits |
0% co-insurance after deductible |
50% co-insurance after deductible |
Subject to specialist office visit co-pay after deduction |
Subject to PCP office visit after deductible |
Subject to PCP office visit co-pay |
|
Diagnostic Services (X-ray, Lab Tests, EKGs) |
0% co-insurance after deductible |
50% co-insurance after deductible |
Subject to specialist office visit co-pay after deduction |
Subject to specialist office visit co-pay after deductible |
Subject to specialist office visit co-pay |
|
Ambulatory Surgery |
0% co-insurance after deductible |
50% co-insurance after deductible |
$100 co-pay after deductible |
$100 co-pay after deductible |
$100 co-pay |
|
Chiropractic Services |
0% co-insurance after deductible |
50% co-insurance after deductible |
Subject to specialist office visit co-pay after deduction |
Subject to specialist office visit co-pay after deductible |
Subject to specialist office visit co-pay |
|
Second Medical and Surgical Opinion |
0% co-insurance after deductible |
50% co-insurance after deductible |
Subject to specialist office visit co-pay after deduction |
Subject to specialist office visit co-pay after deductible |
Subject to specialist office visit co-pay |
|
Prenatal, Postnatal Care in Physician’s Office |
Covered in full |
Covered in full |
Covered in full |
Covered in full |
Covered in full |
|
Preventive Care |
Covered in full |
Covered in full |
Covered in full |
Covered in full |
Covered in full |
|
Mental Health and Substance Use Disorder |
|||||
|
Mental Health Inpatient Treatment |
0% co-insurance after deductible |
50% co-insurance after deductible |
Subject to specialist office visit co-pay after deduction (no limit on days per year) |
Subject to specialist office visit co-pay after deduction (no limit on days per year) |
Subject to specialist office visit co-pay (no limit on days per year) |
|
Mental Health Outpatient Treatment |
0% co-insurance after deductible |
50% co-insurance after deductible |
Subject to specialist office visit co-pay after deduction (unlimited visits per year) |
Subject to specialist office visit co-pay after deduction (unlimited visits per year) |
Subject to specialist office visit co-pay (unlimited visits per year) |
|
Substance Use Disorder Inpatient Detoxification |
0% co-insurance after deductible
|
50% co-insurance after deductible |
Subject to specialist office visit co-pay after deduction (no limit on days per year) |
Subject to specialist office visit co-pay after deduction (no limit on days per year) |
Subject to specialist office visit co-pay (no limit on days per year) |
|
Substance Use Disorder Outpatient Rehabilitation Treatment |
0% co-insurance after deductible |
50% co-insurance after deductible |
Subject to specialist office visit co-pay after deduction (unlimited on days per year) |
Subject to specialist office visit co-pay after deduction (unlimited on days per year) |
Subject to specialist office visit co-pay (unlimited on days per year) |
|
Substance Use Disorder Inpatient Rehabilitation Treatment |
0% co-insurance after deductible |
50% co-insurance after deductible |
Subject to specialist office visit co-pay after deduction (unlimited on days per year) |
Subject to specialist office visit co-pay after deduction (unlimited on days per year) |
Subject to specialist office visit co-pay (unlimited on days per year) |
|
Special Care |
|||||
|
Emergency and Urgent Care |
0% co-insurance after deductible |
50% co-insurance after deductible |
Emergency room: $150 co-pay per visit after deductible Urgent care facility: $70 co-pay after deductible Ambulance service: $150 co-pay after deductible |
Emergency room: $150 co-pay per visit after deductible Urgent care facility: $60 co-pay after deductible Ambulance service: $150 |
Emergency room: $100 co-pay per visit Urgent care facility: $55 co-pay Ambulance service: $100 |
|
Pediatric Vision |
0% co-insurance after deductible |
50% co-insurance after deductible |
Subjected to PCP office visit co-pay after deductible and 30% co-insurance after deductible |
Subjected to PCP office visit co-pay after deductible and 20% co-insurance after deductible |
Subjected to PCP office visit co-pay and 10% co-insurance after deductible |
|
Durable Medical Equipment |
0% co-insurance after deductible |
50% co-insurance after deductible |
30% co-insurance after deductible |
20% co-insurance after deductible |
10% co-insurance |
|
Infertility Diagnosis and Treatment |
No charge |
No charge |
No charge |
No charge |
No charge |
|
Family Planning |
No charge |
No charge |
No charge |
No charge |
No charge |
|
Hearing Aids |
0% co-insurance after deductible |
50% co-insurance after deductible |
30% co-insurance after deductible |
20% co-insurance deductible |
10% co-insurance |
|
Hospice Care |
0% co-insurance after deductible |
50% co-insurance after deductible |
Subject to PCP office visit co-pay after deductible |
Subject to PCP office visit co-pay after deductible |
Subject to PCP office visit co-pay |
|
Skilled Nursing Facility Care |
0% co-insurance after deductible |
50% co-insurance after deductible |
Subject to hospital admission co-pay after deductible |
Subject to hospital admission co-pay after deductible |
Subject to hospital admission co-pay |
|
Dialysis |
0% co-insurance after deductible |
50% co-insurance after deductible |
Subject to PCP office visit co-pay after deductible |
Subject to PCP office visit co-pay after deductible |
Subject to PCP office visit co-pay |
Annual Maximum Limit
|
Select Care Basic |
None |
|
Select Care Bronze |
None |
|
Select Care Silver |
None |
|
Select Care Gold |
None |
|
Select Care Platinum |
None |
*Only on specific covered services
Summary
EmblemHealth offers great coverage and discounts for each of its health insurance plans. However, this is not offered in all states so be sure to check its availability in your area.
Our Comments Policy | How to Write an Effective Comment
28 Customer Comments & Reviews
- Get Coverage as soon as Tomorrow!
- Short term coverage is ideal if you missed enrollment, can't afford traditional insurance, are between jobs, just graduated or retired early.
- Covers: ER & hospitals coverage, Doctors, Labs, Urgent Care & More
- Visit any doctor in their nationwide network; no referral required
- No long term commitment. Budget Friendly.
