NYCE PPO Covers PrEP Medications

Effective July 1st, 2020, the NYCE PPO and HIP HMO plans cover the cost of health care services and medicines for the detection and prevention of HIV, including screenings and pre-exposure prophylaxis (PrEP). This means there is no cost-sharing, including copays, coinsurance or deductibles for HIV prophylaxis (PrEP) medications.

PrEP medications are available, free of charge, when members present their NYCE PPO or HIP HMO card along with a doctor’s prescription at the pharmacies preferred by Emblem Health: Walgreens and Duane Reade. The Welfare Fund CVS Caremark card is not accepted for PrEP medications.

We understand that the coverage for these prescriptions may be cause for confusion, but we believe the savings members will experience will outweigh any initial inconvenience.

If members have been denied, they can appeal using one of the following methods:

By Phone:
1-212-501-4444

In writing by mail:
NYCE PPO
Grievance and Appeals Unit
PO Box 211381
Eagan, MN 55121

Online:
Payer ID: 26992