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Medicaid

Friends and family

Empire is proud to serve Medicaid members in New York. You or your child(ren) may be eligible for Medicaid through Empire if you:

  • Live in Brooklyn, the Bronx, Queens, Manhattan, Staten Island, Nassau or Putnam County
  • Meet certain income, resources, age or disability requirements — Learn more

What you get with Empire

Doctor check up patient

Visits to the doctor

$0

Toothpaste and brush

Dental checkups

$0

Eye chart

Eye exams and glasses

$0

Prescription pills

Low-cost prescriptions

$0-$3


There are no copays for covered services

  • Primary care provider (PCP) visits
  • Immunizations and wellness visits
  • Specialist visits
  • Urgent care
  • Emergency care
  • Lab and X-ray services
  • Pregnancy services
  • Family planning
  • Hospital care
  • Physical therapy
  • Speech and hearing services
  • Behavioral health care (mental and substance abuse services)
  • Smoking cessation services
  • Home health care services
  • Disease management for asthma, diabetes and more

See your member handbook for a full list of benefits in your plan.

Find a Doctor

We believe good dental care is important to your overall health. There are no copays for covered dental services, including:

  • Teeth cleaning twice a year
  • Oral exams
  • X-rays
  • Extractions
  • Fillings
  • Emergency care
  • Dentures (removable or partial)
  • Orthodontics

Empire offers dental care through LIBERTY Dental, an expert in providing high quality dental services. To find or change your dentist, call LIBERTY Dental at 1-833-276-0847, or visit their website.

Go to LIBERTY Dental

There are no copays for covered vision services, including:

  • One eye exam every two years
  • Prescription glasses every two years

See your member handbook for a full list of vision benefits in your plan.

Medicaid Vision Provider Directory

You can get no-cost rides to your medical appointments. You or your provider should call to schedule your ride at least three days before your appointment.

In New York City and Putnam County

Call Medical Answering Services (MAS) at 1-800-850-5340

You will need:

  • Your Medicaid ID number
  • Your appointment date and time
  • The address where you’re going
  • The name of the doctor you’re seeing

In Nassau County

Call LogistiCare at 1-866-481-9488 (TTY 1-866-288-3133)

You will need:

  • Your Empire ID number
  • Your appointment date and time
  • The address where you are going
  • The name of the doctor you are seeing

Are you pregnant? Sign up for our New Baby, New Life℠ Healthy Rewards program and earn debit card dollars for completing healthy activities.

  • $25 for prenatal visit in the first trimester or within 42 days of enrollment into Empire
  • $25 for attending postpartum visit 21 to 56 days after delivery
  • $25 for attending at least six prenatal care visits
  • $25 for baby’s two-week checkup
  • $25 for attending at least six well-child checkups by 15 months of age

Sign up for Healthy Rewards online or call 1-877-868-2004.

Your benefits include a wide range of prescription and over-the-counter (OTC) drugs. We work with Express Scripts (ESI) to provide these benefits.

Your copay for prescriptions is $3 for brand-name drugs and $1 for generic drugs. Members under age 21 and pregnant women do not have copays.

Visit the pharmacy page to find a pharmacy near you and check if your medicine is covered.

Go to Pharmacy page

Referrals

Some services need a referral from your primary care provider (PCP) before getting care. When you need a referral, your PCP will sign a referral form and send you to a doctor in your plan.

You will need to get a referral from your PCP before:

  • Going to a hospital for nonemergency care
  • Getting medicine from a doctor other than your PCP

You do not need a referral for:

  • Women’s health care
  • Pregnancy services
  • Family planning services
  • Emergency services
  • School-based health center services
  • Adult dental care (ages 21 and over)
  • Adult vision care (age 21 and over)
  • Behavioral health and substance use disorder services
  • Certain doctors for children with special health care needs

Preapprovals

Some services require preapproval or prior authorization. This means that you or your doctor must ask Empire to approve those services or benefits before you get them.

You will need preapproval for:

  • Ambulance transportation (emergency air and nonemergency)
  • Chiropractic services
  • Diagnostic testing
  • Durable medical equipment
  • End-stage renal disease services
  • Vision care for people age 20 and younger
  • Home health extended services for people age 20 and younger
  • Home health services for people age 21 and over
  • Hospice services
  • Inpatient acute care hospitalization
  • Certain medicines
  • Mental health rehab services
  • Nurse-midwifery services
  • Organ transplant services
  • Outpatient hospital services including physical therapy, occupational therapy, speech therapy and surgical procedures
  • Pediatric Day Health Care (PDHC) for people ages 20 and older
  • Personal Care Services (PCS) for people ages 20 and older
  • Physician services including medical assessments, treatments and surgical services
  • Podiatry services
  • Post-stabilization care services
  • Radiology services
  • Rehabilitation services: physical therapy, occupational therapy and speech therapy

Already a member? We’re glad you chose Empire.

Pregnant mom cooking

We want you to understand your benefits and receive the best possible care. Here are some resources to help.

Member handbook

Complete benefit information can be found in your member handbook.

Community Service Centers

We’ll help arrange for you and your family to get the benefits you need to get and stay healthy. Come talk to us at any one of our Community Service Centers.

Find the nearest center

Member Services

If you have any questions, call Member Services at 1-800-300-8181 (TTY 711). Our team is available Monday through Friday from 8 a.m. to 8 p.m. and Saturday from 9 a.m. to 5 p.m. You can also log in to your account to send us a message at any time.

Send us a message

24/7 NurseLine

Whether it’s 3 a.m. or a Sunday afternoon, health issues come up. That’s why you can always call our 24/7 NurseLine and speak directly to a nurse. Call 1-800-300-8181 (TTY 711) anytime, day or night.

 
 
NurseLine illustration

24/7 NurseLine

Whether it’s 3 a.m. or a Sunday afternoon, health issues come up. That’s why you can always call our 24/7 NurseLine and speak directly to a nurse. Call 1-800-300-8181 (TTY 711) anytime, day or night.