Medicare AdvantageAdministrativeMedium impact
April 1 Launch of NYC Medicare Advantage Plus Plan
EmblemHealth·NY·Provider News
Effective date
Apr 1, 2022
We identified it
Jun 20, 2026
Summary
Starting April 1, 2022, over 200,000 NYC retirees transitioned to the NYC Medicare Advantage Plus Plan offered by Empire BlueCross BlueShield and EmblemHealth. Out-of-network providers can still treat these patients and receive 100% of Medicare-allowed rates without needing a contract, while in-network providers should continue normal billing processes.
Action Required
Immediately: Billing team should verify if practice is contracted with EmblemHealth Medicare Choice PPO, Empire MediBlue PPO, or BCBS Medicare Advantage PPO networks to confirm in-network status. For out-of-network providers, update billing procedures to accept NYC Medicare Advantage Plus patients and bill at Medicare-allowed rates. Attend the provider webinar at https://bit.ly/2Y9DrBj to understand billing processes.