Medicare AdvantageAdministrativeHigh impact
Do Not Collect Copays for Senior Care Members
EmblemHealth·NY · Family Medicine, Internal Medicine, Chiropractic +11 more·Provider News
We identified it
Jun 20, 2026
Summary
EmblemHealth has suspended the $15 copay for City of New York retirees on the GHI Senior Care Plan for multiple services including office visits, urgent care, therapy services, and diagnostic testing. Billing teams must immediately stop collecting these copays for eligible members.
Action Required
Immediately: Stop collecting $15 copays for City of New York retirees with GHI Senior Care Plan for the following services: office visits (PCP and specialist), urgent care, allergy testing/injections, chiropractic, podiatry, cardiac/pulmonary rehab, vision care, PT/OT/speech therapy, diagnostic lab/x-ray, radiation therapy, and outpatient mental health/substance use services. Front desk staff must verify member eligibility and update billing system to flag these accounts. Training required for all patient-facing staff.