Medicare AdvantageAdministrativeMedium impact
November 2018 Policy Updates
EmblemHealth·NY·Provider News
Effective date
Jan 1, 2019
We identified it
Jun 20, 2026
Summary
EmblemHealth Medicare Advantage is retiring the Essential Network and Medicare Cost Plan at the end of 2018, transitioning all plans to the VIP Prime Network effective January 1, 2019. They are also introducing new plan options including a VIP Go point-of-service plan that doesn't require referrals and expanding coverage to four additional counties in New York.
Action Required
By December 31, 2018: Billing team must update provider network information in billing systems to reflect transition from Essential Network and Medicare Cost Plan to VIP Prime Network for all EmblemHealth Medicare patients. Verify network status for all EmblemHealth Medicare patients and update patient records. Inform providers about new VIP Go plan that eliminates referral requirements.