This article is for providers caring for our members
Effective April 1, 2022, more than 200,000 Medicare-eligible City of New York retirees will move to the NYC Medicare Advantage Plus plan. This plan is offered through an alliance between Empire BlueCross BlueShield (Empire) and EmblemHealth. The effective date for this transition was originally communicated as January 1, 2022.
We’re notifying you because some of the members affected currently receive or may seek care in Massachusetts.
What is the NYC Medicare Advantage Plus plan?
The NYC Medicare Advantage Plus plan is a Medicare Advantage PPO group retiree offering. The plan allows retirees to visit any doctor nationally who accepts Medicare.
What does this mean for you?
| If you’re | Then | You’ll be reimbursed |
|---|---|---|
| In-network (contracted with our Medicare Advantage PPO plans) | You may see City of New York retiree patients. | Your negotiated contracted rate. |
| Out-of-network | 100% of the Medicare allowed rate. |
How to identify these members
Below is a sample ID card to help you identify these members. The “MA” in the suitcase indicates a member who is covered under the Medicare Advantage PPO network. Members have been asked to provide their NYC Medicare Advantage Plus ID card when receiving services rather than their traditional Medicare ID card.
How to submit claims
Submit claims to your local Blue Cross Blue Shield plan, including the amount the member paid. The member’s copay amount will be noted on their ID card for commonly used services. To submit:
- By mail: Submit paper claims to your local Blue Cross Blue Shield plan. Include the three-digit alpha prefix N6Y that precedes the member ID number listed on the front of their card.
- By electronic submission: Submit electronically to your local Blue Cross Blue Shield plan.
Questions?
If you have any questions, please call 1-800-316-BLUE (2583). As always, thank you for the care you provide to our members.
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