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EmblemHealth Group Health Insurance Review, Rate, Doctor Networks – 2020

This article is about our review for Emblem Group Health Insurance, it contains the comprehensive information of the plans pro & cons, specific plan information, how to Make Payment online or over the phone, it’s Frequently Used Forms, Hospital List, links to locate or Find a Doctor and many more.

Emblem Health Insurance Review – 2020 & Beyond

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We are combining Public reviews from Google GMB (Google my business), BBB (Better Business Bureau), Public review from Yelp & our Broker insider insights to give you the single most comprehensive unbiased review.

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If you are looking for FREE Insurance, click here to see if you are qualified.

However, we are not government employees or charities and cannot apply for a white card or free health insurance for those who in need.

Click here for more details information.

EmblemHealth is happy to offer its state-sponsored Medicaid Managed Care, HARP and Child Health Plus plan to eligible individuals and families throughout New York City, Long Island, and Westchester County.

That, however, is not what this article is about.

We are a broker for EmblemHealth commercial, small or large group insurance. Hence, all of our information will be pertinent to the unsubsidized group health insurance only.

I am not sure if EmblemHealth has decided to waste a bunch of money to treat us, brokers, to splurge at this expensive hotel & 2 of the stars that helped the Knicks to its NBA title glory days.

Also, we are not sure if EmblemHealth had spent too much on party & ended up doing this.

Emblem Health is implementing mandatory generic on all Small Group Prescription Drug Benefits

Who is Emblem Health

It is a $10 billion insurance company with 3.1 million members with a very strong presence in NY.

EmblemHealth was created in 2006 through the merger of Group Health Incorporated (GHI) and the Health Insurance Plan of Greater New York (HIP).

Emblem Health Insurance: NY Affordable Health Coverage with Large Provider Network

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Because of coverage changes, Emblemhelath HMO reviews have varied significantly throughout the year. The company used to have extremely limited coverage– making it difficult to find doctors that accept their medical insurance.

However, this July, they greatly expanded their medical provider network to cover the tri-state area.

After these changes, Emblemhealth is a more affordable health insurance option in New York with good coverage.

In general, New York is not the best location to find affordable health insurance. As Trumpcare begins to slowly overtake the ACA, health insurance prices and rates are growing more costly.

This is partially due to the Obamacare mandate repeal, which eliminates the penalty for not having health insurance. As a result, fewer people are opting to buy health insurance and rates are rising.

That’s why Emblem’s healthcare provider expansion this July makes it a good bargain.

About Emblem Healthcare

Emblem Healthcare is based in Lower Manhattan and serves 3.1 million members. They are a major provider of Group Health Insurance to New York State.

Their service area includes New York City and surrounding locations as well as the tri-state area.

Emblem sells medical insurance including individual, family, and group plans, as well as Medicare. Group Health Incorporated (GHI) and Health Insurance Plan of Greater New York (HIP) merged in 2006 to form Emblem.

This merger made them one of the largest not for profit insurers in the nation.

Emblem Health Insurance Plans

Emblem offers only HMO plans– health insurance plans that come with a service network. The plans come in three categories:

Select Care, Select Value, and Essential. The Select Care and Select Value plans come in different tiers. Select Care plans can exist as catastrophic insurance, bronze, silver, gold, and platinum plans. For more details on rates and coverage, view our updated Emblem rates sheet. 

The Select Care plans come at the bronze and silver tiers. These plans have higher deductibles that are also out-of-pocket limits. They also come with vision and dental. Lastly, the Essential plan is for people who qualify based on income requirements.

Emblem Review

Emblem Health has an A+ rating with the Better Business Bureau (BBB). However, the BBB has been known in the past to give good reviews to companies with nothing but negative feedback. Emblem had 75 complaints filed against them in the past three years, 37 of which were closed in the past 12 months. For a company of this size, those numbers are rather low.

In 2014, in which the company was fined $300,000 due to their failure to disclose out-of-pocket costs for out-of-network care. As a result, they agreed to disclose out-of-network fees. This action was taken against GHI, which was a part of Emblem at the time.

On Yelp, it has 114 reviews and only one star. Most negative reviews seem to be about the difficulty in finding doctors near them that accept the insurance. It was so hard to find Emblem health care providers they actually reduced their provider network by 90% at the beginning of the year. Emblem health went from offering all HIP providers to Emblem select care providers– drastically cutting the number of Emblem health hospitals.

However, on July 1st, 2018, Emblem became one of the cheapest health insurance companies in New York. They are expanding their network again, but are not raising prices proportionally. Now, there are 90,000 Emblem health care providers in New York alone. The Emblem provider network also includes 43,000 providers in Connecticut and New Jersey combined. This huge network expansion is now making Emblem one of the most affordable health coverage options. you can find the details of the EmblemHealth provider network expansion below. To see how your provider network may improve, view the differences between the HIP Prime and Select Plans.


emblem health chart of provider expansion

These are available for every plan

– *FREE* Telemedicine.
– GYM REIMBURSEMENT: $200 every six months. $100 for the spouse
– *FREE* DENTAL Exam and cleaning plus more, see attached
– *FREE* VISION Exam, lenses, and contacts cover by EmblemHealth at 80%,
members pay just 20%
– *FREE* WELL WOMAN EXAMS / FREE Routine Gynecological / FREE
– *FREE* Prenatal/Postnatal doctor visits

– *DEDUCTIBLE DOES NOT apply for PCP office visits, lab work, **Urgent
care and Generic Rx. Only Copays.*

Emblem HSA/HRA Plan

Administrative Fee Schedule for HealthEquity

Is Emblem Health Right for You?

If you are looking to buy health insurance, it’s important to compare all your options. First, be sure to view our chart of group health insurance rates. Or, simply fill out a quick form and get an instant health insurance quote online. If you need some help to find the right plan for you, give us a call at 212-484-9888.

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