EmblemHealth VIP Dual (HMO D-SNP) in Nassau County, New York — 2026 plan details

Last updated Jul 18, 2026

Reviewed by Jason Burns, Editorial Steward

Published by Senior Direct Answers · Licensed under Citation License 1.0

EmblemHealth VIP Dual (HMO D-SNP) (H5991-012) is a $59-premium Medicare Advantage HMO D-SNP from EmblemHealth, Inc. available in Nassau County, New York in 2026, with a 3.0-star overall rating, a $9,250 in-network out-of-pocket maximum, and a $615 annual Part D drug deductible.

Plan facts (CMS CY2026 Landscape file)

OrganizationEmblemHealth, Inc.
Plan nameEmblemHealth VIP Dual (HMO D-SNP)
Contract IDH5991
Plan ID012
Segment ID2
Contract year2026
Contract categorySNP
Plan typeHMO D-SNP
SNPYes — Dual-Eligible
Monthly consolidated premium$58.80
Part C premium$0.00
Part D basic premium$58.80
Part D total premium$58.80
Annual Part D deductible$615.00
Maximum out-of-pocket (in-network)$9250.00
Overall star rating3.0

How this plan is structured

  • $59 consolidated premium. A $0 or near-$0 consolidated premium does not remove the Part B premium — the standard 2026 Part B premium is $202.90 per month and still applies. See the 2026 Medicare Part B premium.
  • HMO D-SNP plan type. In an HMO-style Medicare Advantage plan, in-network care and primary-care referral rules generally apply. See how Medicare Advantage HMO and PPO plans differ.
  • $9,250 in-network out-of-pocket maximum. The MOOP is the annual cap on what a member pays in-network for covered Part A and Part B services. See how the Medicare Advantage MOOP works.
  • Service area = Nassau County. Medicare Advantage plans are sold by service area; moving out of the plan's service area triggers a Special Enrollment Period to switch plans. See how moving changes your Medicare options.

How it compares in Nassau County

The CMS CY2026 Landscape file lists 66 Medicare Advantage plans in Nassau County, New York, of which 3 carry a 5.0-star overall rating and 18 have a $0 consolidated monthly premium. Consolidated premiums range from $0.00 to $252.00 per month, and in-network out-of-pocket maximums range from $0.00 to $9250.00.

Other 5.0-star Medicare Advantage plans in Nassau County (first three alphabetically):

PlanOrganizationPremiumMOOP
Anthem HealthPlus Full Dual Advantage LTSS 2 (HMO D-SNP)Elevance Health, Inc.$58.80$9250.00
Anthem Medicare Advantage 2 (HMO-POS)Elevance Health, Inc.$56.00$8300.00
Anthem Veteran 2 (HMO-POS)Elevance Health, Inc.$6800.00

For the full county plan directory, see all Medicare plans in Nassau County, New York.

How to verify your doctors take this plan

Network participation changes throughout the year; we hold no provider-network data, so verify directly with these three sources before you decide:

  1. Open the plan's official Medicare.gov page and use its provider-directory link: Medicare.gov Plan Finder — H5991-012.
  2. Call the plan (EmblemHealth, Inc.) using the member-services number listed on that plan page and ask whether each doctor, hospital, and pharmacy is in-network for 2026.
  3. Get free, unbiased help from your State Health Insurance Assistance Program (SHIP) — see free unbiased Medicare help from SHIP.

What H5991-012 means

CMS assigns every Medicare Advantage and Part D offering a plan identifier made of three parts. In H5991-012, the leading H marks the contract type (H = Medicare Advantage / Part C contract), the four digits 5991 are the contract number issued to the organization, and the three-digit 012 is the plan benefit package under that contract. The segment ID 2 identifies the service-area segment within the plan (0 = the default single segment).

Frequently asked questions

Is EmblemHealth VIP Dual (HMO D-SNP) an HMO or PPO?

EmblemHealth VIP Dual (HMO D-SNP) is an HMO D-SNP — a Health Maintenance Organization-style Medicare Advantage plan, meaning in-network care and referral rules generally apply.

Does EmblemHealth VIP Dual (HMO D-SNP) include prescription drug coverage?

Yes — EmblemHealth VIP Dual (HMO D-SNP) is a Medicare Advantage plan with prescription drug coverage (MA-PD) and a $615.00 annual Part D drug deductible for 2026.

What is the maximum out-of-pocket cost for EmblemHealth VIP Dual (HMO D-SNP)?

The 2026 in-network maximum out-of-pocket limit for EmblemHealth VIP Dual (HMO D-SNP) is $9250.00, per the CMS CY2026 Landscape file.

What counties offer EmblemHealth VIP Dual (HMO D-SNP) (H5991-012)?

EmblemHealth VIP Dual (HMO D-SNP) (H5991-012) is offered in 24 New York counties: Albany County, Bronx County, Broome County, Columbia County, Delaware County, Dutchess County, Greene County, Kings County, Nassau County, New York County, Orange County, Putnam County, Queens County, Rensselaer County, Richmond County, Rockland County, Saratoga County, Schenectady County, Suffolk County, Sullivan County, Ulster County, Warren County, Washington County, and Westchester County.

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