EmblemHealth Providers for At-Home Eye, Foot, and Hearing Care

It depends on your plan. According to EmblemHealth, its 2026 VIP Medicare Advantage plans, including VIP Gold, VIP Gold Plus, VIP Value, VIP Dual, VIP Dual Enhanced, and VIP Dual Reserve, do not require referrals, so members can schedule specialist appointments without first getting one from a primary care provider. EmblemHealth lists several of its Medicaid, Child Health Plus, and commercial plans as not requiring referrals as well. Even without a referral requirement, some services may need prior authorization, and plan rules can change from year to year. Your Evidence of Coverage or EmblemHealth Member Services can confirm what applies to your plan. Once you know your plan’s requirements, Aspire Healthcare Solutions can help schedule at-home eye care, podiatry, hearing care, or lab work.

EmblemHealth Medicare Advantage plans cover the podiatry services Original Medicare covers, which include foot exams and treatment for people with diabetes-related nerve damage and medically necessary care for injuries and conditions of the foot and ankle. Routine foot care, such as basic nail trimming for people without a qualifying medical condition, is generally not covered by Original Medicare, although plan benefits can differ. EmblemHealth’s plan materials list foot care among covered services, with cost sharing that varies by plan. To confirm what your plan includes and what you would pay, check your Summary of Benefits or call Member Services. Aspire Healthcare Solutions offers mobile podiatry at home for EmblemHealth members, including diabetic foot care, treatment for foot pain, and orthotics.

All EmblemHealth Medicare Advantage plans cover the eye care Original Medicare covers, including a yearly diabetic retinopathy exam for people with diabetes and medically necessary exams for eye conditions. Many EmblemHealth VIP Medicare plans also include an annual allowance for routine eyewear, which can help with the cost of glasses. Allowance amounts and rules differ from plan to plan, so your Summary of Benefits is the best place to confirm your benefit. Aspire Healthcare Solutions provides mobile optometry at home, including comprehensive eye exams, dilated eye exams, retinal imaging, vision testing, and glasses, along with diabetic retinal exams that help protect long-term vision for members living with diabetes.

GHI and HIP are the two New York health plans that came together to form EmblemHealth, and both names are still part of the EmblemHealth family. Many members, especially those who have had coverage for many years, still refer to their plan as GHI or HIP. In EmblemHealth’s Medicare materials, Health Insurance Plan of Greater New York (HIP) is identified as an EmblemHealth company that holds the Medicare contracts for its VIP Medicare plans. If you are unsure which EmblemHealth plan you have, the name and phone number on your member ID card can help you find out. Aspire Healthcare Solutions provides at-home specialty care for members who know their coverage as EmblemHealth, GHI, or HIP.

EmblemHealth VIP Dual is a Dual-Eligible Special Needs Plan, or D-SNP, built for people who are enrolled in Medicare and have full New York State Medicaid. EmblemHealth also offers VIP Dual Enhanced and VIP Dual Reserve, which serve the same population with different networks and benefit designs. These plans combine Medicare coverage with extra benefits such as dental, an eyewear allowance, a hearing aid allowance, and an over-the-counter allowance, and EmblemHealth states that they do not require referrals for 2026. Benefits vary by plan, so your Summary of Benefits and Evidence of Coverage explain exactly what you receive. Many dual-eligible members manage chronic conditions or have difficulty traveling, and Aspire Healthcare Solutions can bring eye care, foot care, hearing care, and lab testing directly to them at home.