Quick Start Guide to Your Benefits

Quick Start Guide

to Your Beneﬁts

Enhanced Care Plus Plan

Welcome to the EmblemHealth Enhanced Care Plus plan.

We are here to help you get the most from your health care

beneﬁts. Here’s what you need to know to get started:

Renew Your Medicaid Coverage

Your continued enrollment in Medicaid is important. To stay enrolled, you need to recertify

your eligibility once a year. If you have not recertiﬁed as this deadline approaches, we will

send you reminders.

The Role of Your Primary Care Doctor

A primary care Doctor (PCP) manages your health care and can make referrals to any

specialists you might need. Call your PCP whenever you need medical care, except in an

emergency. The back of your Welcome Kit letter and member ID card show the name of

your PCP.

Change a Doctor

If there is no PCP listed, or if you would like to change your PCP, please follow the

instructions below:

• Once registered, you can change your PCP on the homepage of your member portal

at my.emblemhealth.com.

• Click the “Change PCP” link under your Plan Information.

• Compare providers and doctor proﬁles to ﬁnd the provider that best meets

your needs.

You can also search as a Guest under Find a Doctor at emblemhealth.com. You can also

request a paper directory by calling the Customer Service number on your ID card. A

representative will be happy to help.

Need a Doctor? Consider AdvantageCare Physicians

AdvantageCare Physicians (ACPNY), part of the EmblemHealth family of companies, is a

primary and specialty care practice that cares for the whole you. This means ACPNY doctors

and providers consider the physical, mental, and lifestyle factors that aﬀect your health.

With oﬃces in all ﬁve boroughs (includes BronxDocs, an aﬃliate of ACPNY) and on Long

Island, ACPNY oﬀers convenient hours and same- and next-day appointments in many

oﬃces, along with related services, such as lab and radiology. Go to acpny.com to see a

full list of services and locations.

EmblemHealth insurance plans are underwritten by EmblemHealth Plan, Inc., Health Insurance Plan of Greater New York (HIP) and EmblemHealth Insurance Company.

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Go paperless! Keep your

health care information online

in one secure, convenient

place. To update your

paperless preferences:

• Sign in to your account at

my.emblemhealth.com.

• Click your name in the top right

corner and select ‘My Proﬁle.’ (If

you’re using a mobile device, tap

the Menu option.)

• Click the ‘Communication

Preferences’ tab.

• From there, click the ‘Edit’ button

to make changes.

Note: We may be required to send

you some documents by mail or some

documents electronically, no matter

your preference.

If you’re new to the portal, simply go to

my.emblemhealth.com, click Register,

and ﬁll in the required information.

Once your account is validated, follow

the steps to create a new username and

password. You’ll be able to see your plan

beneﬁts, ﬁnd doctors and hospitals,

choose a PCP, request a member ID card,

and much more.

On the go? Download our mobile app

for your Android or iOS devices at

emblemhealth.com/app.

myEmblemHealth:

Our member portal

Choose a Network Doctor

• Sign in to your member portal at my.emblemhealth.com. (Don’t have an account yet? Click

“Register” at the bottom of the page to set one up.)

• Go to the “Find Care” tab. The portal automatically has your plan and network

information selected.

• You can choose any criteria for your search, and the results will only include providers

available in your selected plan or network. You’ll see a list of providers, view their

proﬁles, contact information, and more.

You can also search as a Guest under Find a Doctor at emblemhealth.com. You can also

request a paper directory by calling the Customer Service number on your ID card. A

representative will be happy to help.

Vision

Vision services are administered by EyeMed with CPS Optical. To reach an EyeMed Customer

Service representative, call 877-324-2791, Monday to Saturday, 7:30 a.m. to 11 p.m. or Sunday,

11 a.m. to 8 p.m. You can ﬁnd more information on EyeMed’s website at eyemed.com.

Dental Beneﬁts

Dental services are administered by Healthplex. To reach a Healthplex Customer Service

representative, call 855-910-2406, Monday to Friday, 8 a.m. to 6 p.m. You can ﬁnd more

information on Healthplex’s website at healthplex.com/member.

Your Member ID Card

You will receive a member ID card within 14 days of your eﬀective date of enrollment. If you

don’t receive it, please call Customer Service at 855-283-2146 (TTY: 711). Our hours are 8 a.m.

to 6 p.m., Monday through Friday. A Customer Service representative will be happy to help.

How to Get Urgent Care

If you have an injury or an illness that is not an emergency but still needs immediate care, or

you need to see a doctor after hours or on weekends, you can get urgent care 24 hours a day,

seven days a week.

Get a list of participating urgent care center locations online at emblemhealth.com or call

Customer Service at 855-283-2146 (TTY: 711). Our hours are 8 a.m. to 6 p.m., Monday through

Friday. A Customer Service representative will be happy to help.

Emergency Room

You should go to the emergency room (ER) for medical emergencies. Medical emergencies need

a doctor’s care right away. These emergencies include but are not limited to: heart attacks,

strokes, broken bones, major burns, head injuries, and when you feel you might hurt yourself or

others. Call 911 or go to the nearest ER. The ER is open 24 hours a day, seven days a week.

Emblem Behavioral Health Services Program

Your behavioral health provider can help with emotional wellness as well as substance abuse

and addiction. To ﬁnd a network provider, call 888-447-2526 (TTY: 711). Our hours are 8 a.m. to

5 p.m., Monday through Friday. A Customer Service representative will be happy to help.

Neighborhood Care Provides Support and Wellness in the

Neighborhood

EmblemHealth Neighborhood Care locations provide in-person customer support, help in

gaining access to community resources, and health and wellness programs.

From learning a language to ﬁtness classes to diabetes management and much more — at no

cost! Visit emblemhealth.com/neighborhood for locations and hours.

Enhanced Care Plus Plan

Check out the Health Assessment

(HA) tool on our member portal.

To sign in, enter your user ID and

password, ﬁnd the “Manage Your

Health” tab, and click on “Health

Assessment.”

This tool gives you a “snapshot”

of your current health based on

how you answer the questions.

You will get a personalized

report with tips for improving

and maintaining your health, and

preventing serious illness.

Your results are conﬁdential, but

you can share them with your

doctor when talking about your

health care.