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More on the New Emblem (GHI) Copays

October 26, 2022 am31 10:37 am

Yesterday I wrote about the new copays. A couple more details today.

Advanced Imaging

We are talking MRIs, CAT scans, PET scans, NMR, and other stuff. Copays in network were $50. But the City and the MLC and Mulgrew and the Insurance companies found a cost savings. (Cost savings mean you get less medical care, or you have a harder time accessing medical care, or you have to pay more out of pocket for medical care. “Cost Savings” is short for “Cost Savings for them, at our expense”)

In any case, the way they are going to charge us more is by declaring everyone to be out of network, with double the copay ($100 instead of $50).

Me? In a dozen years I’ve had six “advanced images” – an emergency CT for what turned out to be kidney stones (twice). One almost needed surgery. Two MRIs for a large tumor, which turned out to be benign (they weren’t sure until they removed it. A CT looking for a foreign object I swallowed. And an MRI looking at a possible issue with my pancreas (false alarm). And every one of those images was done either in the emergency department, because, well fuck. Or in the imaging department of the hospital that my doctor is part of. I have never gone to a third party for a CT, and would never think of doing so.

But this cost savings says that copays double except for preferred providers. And who are those? Sloan Kettering. Hospital for Special Surgery. And RadNet.

Sloan Kettering? That’s Manhattan, with satellites in White Plains, and Long Island?

Hospital for Special Surgery? That’s Manhattan? With one site each in Brooklyn, Queens, and White Plains? And a few on Long Island?

RadNet? What’s RadNet? It appears to be, in the NYC area, Lenox Hill Radiology. 17 sites in Queens. 12 in Manhattan. 17 in Brooklyn. 3 on Staten Island (smallest borough). And 3 in the Bronx.

The Bronx is getting screwed, again, by Emblem and Unity. First, all of our Montefiore copays went up October 1. And then we get disproportionately the fewest “preferred” radiology sites. No Sloan Kettering. No Hospital for Special Surgery. And only three “RadNet” storefront sites.

And what do the Bronx sites look like?

Google Maps needs a new photo. That’s it, on the left, with the orange grate
Google Maps needs a new photo. It’s the “office space available” next to Little Caesars
It’s in the big building, behind the 6 train.

I’m really supposed to get to one of these (at least Little Caesars has parking) rather than use the center associated with my doctor?


I got a letter from Emblem on Saturday October 22 informing me of the change. The letter was dated October 20. But I got nothing from the UFT. And the Montefiore changes (which affect me) were effective October 1. Hmm. They billed me the copay on October 17. That’s kind of dicey – before they notified. But they also billed me on September 26, 5 days before the change was supposed to be effective. That’s even dicier. I contacted the Welfare Fund – maybe they can address this positively.

Received October 22. Dated two days earlier. Effective THREE WEEKS earlier.
They billed me before notifying me of the change! (would have been zero copay before)
They billed me $30, even though the change was not yet effective! September 26! For an October 1 change! I expected zero copay.
3 Comments leave one →
  1. Unshackled after 28 Years permalink
    October 26, 2022 pm31 1:47 pm 1:47 pm

    Emblem Health informed me three weeks ago that my out of network co-pays for PT is now $50 up from $30. I have to say, I clearly saw this coming when the last contract was voted on. There was/is a clause in there about unspecified healthcare savings that was voted on and approved. I told everyone I knew not to vote NO on this contract, as this was going to come back and bite all of us, which it is now doing and will continue to do so for a long time/ perhaps our entire lives, Which for many of us will be shortened because of the hesitation to go to a hospital or doctor because of money.


  1. Did the UFT make an announcement about copay increases? | JD2718
  2. UFT still hasn’t told members about October 1 copay increases | JD2718

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