Posted in In The Know Series, Insurance, Training

EmblemHealth Plans that DO NOT require a REFERRAL-2019

The following is the list of all the EmblemHealh Plans for 2019 that do not require a referral from their primary to see a specialist.

Commercial Plans:

Access I/II, EmblemHealth Platinum Choice, EmblemHealth Gold Choice, EmblemHealth Silver Choice, EmblemHelath Gold Premier 1, EmblemHealth Silver Plus1, EmblemHealth Silver Premier, EmblemHealth Platinum Premier, EmblemHealth Gold Premier, EmblemHealth EPO Value, EmblemHealth EPO Value HDHP

Medicare Advantage Plans:

EmblemHealth VIP  Go (HMO-POS) plans, EmblemHealth Affinity Medicare Passport Essentials (HMO), EmblemHealth Affinitiy Medicare Passport Essentials NYC (HMO), EmblemHealth Affinity Medicare Utimate (HMO SNP), and EmblemHealth Affinity Medicare Solutions (HMO SNP)

Remember if the EmblemHealth HIP plan has a Montefiore Logo and you are going to the provider associated with Montefiore you still also DO NOT Require a referral to see that specialist.



My name is Kate Patskovska, CPB. I am an Independent Medical Biller CPB (AAPC) and an owner of KR2 Medical Billing. KR2 Medical Billing is a full service Consulting/Medical Billing Business that is dedicated to educating, consulting, and overall improving the "financial health" of your medical practice.

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