West Islip, NY 11795
ph: 631-539-4640
fax: 631-587-6146
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MediBlueSM Value (PPO) | |||
MediBlueSM Plus (PPO) - available in Suffolk county | |||
MediBlueSM Plus (PPO) – available in Dutchess, Orange, Putnam, Rockland, Sullivan, Ulster, Westchester counties | |||
MediBlueSM Plus (PPO) – available in Bronx, Kings, Nassau, New York, Queens, Richmond counties | |||
| Plan Name | Plan Brochure | Summary of Benefits | Evidence of Coverage |
MediBlueSM Value (PPO) | |||
MediBlueSM Plus (PPO) | |||
Click here to see the Service Area for the PPO plans listed above. | |||

2010 Summary of Benefits (Current as of 10/01/2009)
| HIP VIP(HMO), HIP VIP PLUS(HMO) and HIP VIP RX Carve out(HMO) |
| NYC |
| Nassau/Suffolk |
| Westchester |
| HIP VIP Dual Eligible (HMO) and HIP MA Advantage (HMO) |
| NYC/Nassau/Suffolk/ Westchester |
| HIP Part D New York Standard and HIP Part D New York Enhanced |
| New York State |
GHI Medicare Choice PPO offers the comprehensive coverage and health care choices you deserve. Following is a summary of benefits, including premiums and cost-sharing for in-network and out-of-network benefits.
2010 Summary of Benefits (Current as of 10/01/2009)
| GHI Medicare PPO I,GHI Medicare PPO II, and GHI Medicare PPO III |
| NYC |
| Nassau/Suffolk |
| Westchester/Dutchess/Ulster/Putnam/Rockland/Orange |
| GHI Medicare PPO Any Dual and GHI Medicare PPO Value |
| NYC/Westchester/Rockland |
| GHI Medicare Prescription Drug Plan |
| New York State |
West Islip, NY 11795
ph: 631-539-4640
fax: 631-587-6146
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