EmblemHealth

City workers, teachers, transit employees, and public sector staff: your EmblemHealth plan works here. Moses Medical at 871B Westchester Ave in the Bronx accepts both HIP HMO and GHI PPO plans. If you got your insurance through the City of New York, the MTA, or another public employer, you likely have one of these two plans. They look similar but work differently.

HIP vs. GHI: What Each Covers

Both plans cover the same services at Moses Medical:

• Primary care for physicals, sick visits, and chronic condition management
• Primary care for diabetes, high blood pressure, and cholesterol
• Cardiology for heart evaluations and blood pressure management
• Dermatology for skin conditions, rashes, and mole checks
• Behavioral health for therapy, counseling, and psychiatric care
• Podiatry for diabetic foot exams and heel pain
• Lab services drawn and processed on-site

The difference is how you access care and what you pay per visit.

HIP HMO requires you to pick a primary care provider. All specialist visits go through your PCP, who writes referrals. In exchange, your copays are lower. You must stay in-network.

GHI PPO lets you see specialists without a referral and go out of network if you choose. The tradeoff is higher copays per visit. Staying in-network at Moses Medical keeps those costs down.

If you have a choice during open enrollment, think about how you use care. HIP works well if you want one doctor coordinating everything. GHI works better if you want to see specialists on your own schedule.

Getting Your EmblemHealth Card Set Up

HIP HMO members: You need a PCP on file before you can see specialists. Choose a Moses Medical provider by calling EmblemHealth at 1-877-411-3625 or telling our front desk. Referrals happen the same day in most cases.

GHI PPO members: Book any appointment directly. No PCP designation required.

Everyone: Bring your EmblemHealth card and a photo ID. Our team checks your eligibility electronically and confirms your copay before you see a provider. If a service needs prior authorization, we file it for you.

Six Ways to Use More of Your Coverage

1. Book your annual preventive visit. Both HIP and GHI cover a yearly wellness exam at no extra cost. This includes bloodwork and screenings. A yearly exam costs nothing. A missed diagnosis costs a lot.

2. Use behavioral health benefits. Public sector work can be grinding. Long shifts and difficult situations add up. EmblemHealth covers behavioral health visits including therapy and psychiatric care. These are medical appointments like any other.

5. Stay in-network. For HIP members, out-of-network care is on your dime. For GHI members, in-network visits mean lower copays and no surprise balance bills.

6. Keep follow-up simple. See your PCP, get a referral when needed, and have lab work drawn in the same clinic. That matters when you are on a shift schedule.

Call (646) 741-2111 to schedule your appointment, or walk in during office hours. We are on Westchester Ave near the 2/5 trains at Longwood Ave.