Eco Dental NY accepts every major EmblemHealth dental plan — GHI Dental, HIP Prime Dental, EmblemHealth Enhanced Care (Medicaid), EmblemHealth Medicare Advantage dental, and the EmblemHealth Essential plan. Whether you have EmblemHealth through your job, through Medicare, or through New York Medicaid, your preventive visits (cleaning, exam, X-rays) are fully covered and major work is in-network at negotiated rates.
Call (718) 368-3368 with your member ID or book online. Benefits verification takes under 2 minutes.
EmblemHealth Plans We Accept
- GHI Dental (Group Health Inc.) — most NYC city worker and union members
- HIP Prime Dental — HIP Health Plan members
- EmblemHealth Enhanced Care — Medicaid managed-care plan
- EmblemHealth Medicare Advantage — Part C plans with dental rider (Medicare HMO Advance Care, Medicare PPO Plus)
- EmblemHealth Essential — individual and family plans
- EmblemHealth Federal Employee Program (FEP) dental
What EmblemHealth Dental Plans Cover (2026)
Coverage varies by specific plan, but EmblemHealth follows the standard insurance 100/80/50 structure:
- Preventive (100%) — Cleanings and exams every 6 months, bitewing X-rays yearly, panoramic every 3 years, fluoride for children, sealants for permanent molars in kids
- Basic Restorative (80%) — Fillings (composite or amalgam), simple extractions, root canals on anterior teeth, periodontal scaling and root planing
- Major Restorative (50%) — Crowns (porcelain-fused-to-metal, all-ceramic), dentures (complete and partial), bridges, molar root canals, surgical extractions, periodontal surgery
- Orthodontia — Most GHI Dental and HIP Prime plans include orthodontic coverage for dependents (lifetime maximum $1,000-2,500). Adult orthodontia is plan-dependent.
- Implants — Many newer EmblemHealth plans include partial implant coverage (replacing a single tooth missing for 1+ year). Always verify before treatment.
GHI Dental — The Most Common EmblemHealth Plan
If you work for the City of New York, MTA, NYCHA, or a unionized public-sector employer, you almost certainly have GHI Dental (administered by EmblemHealth). GHI has one of the most generous dental fee schedules in NYC. Eco Dental NY has been an in-network GHI provider since 2018 — we know the codes, the bundling rules, and the prior-auth thresholds.
Typical GHI Dental member out-of-pocket at Eco Dental NY:
- Cleaning + exam + X-rays: $0
- 1-2 surface composite filling: $20-45
- Molar root canal: $250-400
- Porcelain-fused-to-metal crown: $300-500
- Single dental implant + crown: $1,800-2,500 (after coverage)
HIP Prime Dental — Health Plan of New York
HIP Prime Dental members get full preventive coverage and a structured basic/major schedule similar to GHI. The main difference: HIP has tighter prior-authorization requirements for major work and a separate fee schedule. We submit electronically; turnaround is typically 5-10 business days.
EmblemHealth Medicare Advantage — Dental for Seniors
If you have EmblemHealth Medicare Advantage with a dental rider (Medicare HMO Advance Care, Medicare PPO Plus, or the SmartFit plans), your dental benefit usually includes:
- 2 cleanings and 2 exams per year — $0 copay
- Annual X-ray series — $0
- An annual allowance ($1,000-2,000 depending on plan) toward basic and major restorative work
- Some plans include partial denture coverage (replacement every 5 years)
Important: Original Medicare (Part A and B alone) does NOT cover routine dental. If your card says “Medicare” but not “EmblemHealth Medicare Advantage,” you may not have dental coverage — we will verify before your visit.
Why EmblemHealth Members Choose Eco Dental NY
- In-network since 2018 — thousands of EmblemHealth claims processed. Same-day electronic submission.
- No balance billing — we accept EmblemHealth’s negotiated rate; you only pay your copay/coinsurance.
- Treatment plan in writing — line-by-line cost breakdown for every procedure.
- Languages — English, Russian, Polish, Ukrainian, Uzbek.
- Easy to reach — 2384 Ocean Avenue, 2 blocks from Avenue U Q-train, on B49/B36 bus lines.
- Same-day emergencies Mon-Fri for EmblemHealth members.
EmblemHealth FAQ
Is GHI the same as EmblemHealth?
GHI (Group Health Inc.) is part of the EmblemHealth family — EmblemHealth administers GHI Dental. If your insurance card says GHI Dental, you have EmblemHealth coverage and we are in-network.
I just got a new job with NYC. When does dental coverage start?
Most NYC employee dental plans (administered by GHI/EmblemHealth) start on the first day of the month after your hire date. We can verify your effective date before your visit.
Does EmblemHealth cover dental implants?
Some EmblemHealth plans now cover partial implant placement (typically 25-50% of the surgical fee) when the tooth has been missing 1+ year and bone is adequate. Prior authorization is required. We submit X-rays and a treatment narrative; response takes 7-14 days.
What if I have EmblemHealth Medicare Advantage but my plan does not include dental?
Some Medicare Advantage plans require a separate dental rider. If your plan does not include dental, we offer cash-pay pricing and CareCredit 0% financing as a backup.
Do you do crowns and dentures on the same visit as cleanings?
Same-day cleaning + exam + X-rays — yes, always at the first visit. Crowns and dentures require multiple appointments (impressions, lab work, fitting). We bundle visits when possible to reduce time off work.
Can I use my EmblemHealth flex spending (FSA/HSA) for what insurance does not cover?
Yes. FSA and HSA funds can be applied to your out-of-pocket portion. We provide itemized receipts coded for FSA/HSA reimbursement.
I have GHI Dental but my spouse has Healthplex. Can we coordinate?
Yes. We coordinate benefits — your primary insurance pays first, secondary covers the gap, often reaching 90-100% combined coverage on major procedures. Bring both insurance cards to your first visit.
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