$15 Copay Resumes Jan. 1 for CNY Senior Care

Beginning Jan. 1, 2025, the $15 copayment for the EmblemHealth-GHl portion of the Senior Care Plan will resume. Senior Care members will be required to pay a $15 copay each time they use the health services listed below. Copays are limited to one copay per provider per date of service.

If you are a provider delivering the following services for Senior Care Plan members after the start of the new year, you will need to collect the required $15 copay:

  • Primary care provider (PCP) office visits. 
  • Specialist office visits.                                                       
  • Allergy testing/injections.                                                   
  • X-rays.                                           
  • Laboratory tests.  
  • Complex diagnostic and radiology services.                     
  • Radiation therapy.                                                             
  • Urgent care services.                                                        
  • Emergency care (professional component).                     
  • Mental health care (outpatient).                            
  • Substance use disorder services (outpatient).      
  • Physical, occupational, and speech therapy.        
  • Cardiac rehabilitation.                                                        
  • Pulmonary rehabilitation.                                       
  • Chiropractic care.
  • Podiatry care.                                                                    
  • Vision care.                                                                      

Please note: Senior Care Plan members are responsible for the annual Medicare Part B deductible and $50 GHI Senior Care deductible.

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