Medicare AdvantageAdministrativeHigh impact
$15 Copay for CNY Senior Care
EmblemHealth·NY·Provider News
Effective date
Jan 1, 2025
We identified it
Jun 20, 2026
Summary
Starting January 1, 2025, all CNY Senior Care Plan members must pay a $15 copay for most healthcare services including office visits, diagnostics, and therapies. Billing teams must collect this copay at the time of service for affected members.
Action Required
Immediately: Update billing system and front desk procedures to collect $15 copay from CNY Senior Care Plan members for all covered services (PCP visits, specialist visits, lab tests, X-rays, therapy services, etc.). Train front desk staff to identify these members and collect copay before service. Update encounter forms to flag CNY Senior Care members. One copay per provider per date of service limit applies.