Finding Care in New York

OB/GYNs That Take EmblemHealth (GHI and HIP): How to Find One in New York

By the Find Her Doctor editorial team · Updated November 1, 2026 · 4 min read

To find an OB/GYN that takes EmblemHealth, first check whether your card says GHI or HIP, because they're different plan types with different networks. Then search EmblemHealth's provider directory for your specific plan, filter for Obstetrics & Gynecology or midwives near you, and call the office to confirm they take your plan at that location.

The most common mistake is calling an office and asking, "Do you take Emblem?" The front desk says yes, and three months later you get a bill, because they take GHI and you have HIP, or they take your plan at their Manhattan office but not the one in Queens. The steps below are built to prevent exactly that.

EmblemHealth, GHI and HIP: what the names mean

EmblemHealth formed in 2006 when Group Health Incorporated (GHI) and the Health Insurance Plan of Greater New York (HIP) merged. Both names are still in use:

Name on your card How New York classifies it What it usually means for OB/GYN care
HIP (EmblemHealth) Commercial HMO; also Medicaid, Child Health Plus and Essential Plan Stay in network except for emergencies; check whether a primary care selection is required
GHI (EmblemHealth) Commercial PPO In-network care costs least; some plans pay toward out-of-network care

Source: NYS Department of Health 2024 Managed Care Consumer Guide plan categories. Many New York City public employees and retirees have GHI or HIP coverage through their job, so the specific plan matters a lot. Your certificate of coverage spells out the rules.

The seven-step check

  1. Look at your card for GHI or HIP, plus any plan or network name. Snap a photo of the front and back.
  2. Log in to the EmblemHealth member site so the directory filters to your plan, rather than searching as a guest.
  3. Search for "Obstetrics & Gynecology," "Midwife" or "Maternal-Fetal Medicine" near your ZIP code.
  4. Match the address. Providers often work at several offices, and network status can differ by location.
  5. Compare in our directory. Browse EmblemHealth providers, or start with Queens, Brooklyn, Staten Island or Nassau County.
  6. Call the office and use this exact script: "Do you take EmblemHealth [GHI or HIP], [plan name], at [this address], and is Dr. [name] taking new patients?"
  7. Call EmblemHealth member services to double-check, and write down the date, the rep's name and a reference number.

Pregnancy care with EmblemHealth

All EmblemHealth plans cover pregnancy care, including prenatal visits, recommended tests and ultrasounds, delivery and postpartum care. What differs is what you pay and where you can go.

  • Check the delivering hospital too. Your OB/GYN or midwife delivers at specific hospitals. Make sure the hospital is in your EmblemHealth network, not just the doctor.
  • Ask about bundled billing. Many OB practices bill routine prenatal care, delivery and the postpartum visit as one global fee after the birth. Ask how and when they bill and what your share will be, so a large bill months later isn't a surprise.
  • HIP Medicaid members are covered by New York's Medicaid perinatal care standards: a first prenatal visit within 3 weeks of asking in the first trimester, 2 weeks in the second and 1 week in the third. If an office can't meet that, call the plan and ask for help getting an appointment.

Midwives and high-risk care

Certified nurse midwives offer prenatal care, labor and birth, and routine gynecology. Many work within OB/GYN groups or hospital teams. Browse certified nurse midwives and confirm each with EmblemHealth.

If you need a high-risk pregnancy specialist, ask your OB/GYN which in-network maternal-fetal medicine practices they refer to. If no in-network specialist has the right expertise, New York law requires managed care plans to refer you to an appropriate provider.

Gynecology visits with EmblemHealth

An annual well-woman visit, cervical cancer screening and birth control counseling are preventive services that are typically covered without cost-sharing in-network under federal and New York rules. A visit for a problem, like pelvic pain or abnormal bleeding, may have a copay. If you plan to bring up a new symptom at your preventive visit, ask the office how it'll be billed.

If something goes wrong

  • The directory was wrong. If you relied on EmblemHealth's directory or a phone answer and the provider turned out to be out of network, federal and New York rules generally limit you to in-network cost-sharing. This is why the screenshots and reference number matter.
  • Your OB/GYN leaves the network mid-pregnancy. Ask EmblemHealth for transitional care. New York law protects pregnant patients in an ongoing course of treatment.
  • You're denied a specialist. Ask for the denial in writing and ask about appeals, including external appeal through the NY Department of Financial Services.

Our full checklist: how to check if an OB/GYN is in-network.

Tips for NYC employees and retirees

If your EmblemHealth coverage comes through a city job or union (teachers, police, transit and many others), your benefits may come from a specific city plan with its own rules. Before choosing an OB/GYN:

  • Check the plan booklet from your employer or union welfare fund.
  • Ask whether services like fertility treatment are covered through a separate rider.
  • Talk to HR or your union benefits office before switching plans at open enrollment while pregnant, since a switch can change your doctor and hospital network mid-pregnancy.

When to see a doctor

Book a gynecology visit for bleeding between periods or after sex, bleeding after menopause, pelvic pain, an abnormal Pap or HPV result, or a breast lump. If you're pregnant, go to labor and delivery or an emergency room right away for heavy bleeding, severe belly pain, a severe headache, vision changes, leaking fluid, fever, or fewer baby movements. Emergency care doesn't need plan approval.

Frequently asked questions

Is GHI the same as EmblemHealth?

GHI and HIP are the two companies that merged to form EmblemHealth in 2006. Many members still carry cards that say GHI or HIP, and the names still describe different plan types and networks.

What is the difference between GHI and HIP for seeing an OB/GYN?

In New York's managed care reporting, HIP plans are HMO-type products and GHI plans are PPO-type products. HMO plans generally cover only in-network care except emergencies, while PPO plans may pay something toward out-of-network care. Your certificate of coverage has the exact rules.

Does EmblemHealth have Medicaid and Essential Plan coverage?

Yes. HIP (EmblemHealth) reported Medicaid, Child Health Plus and Essential Plan results for New York City, Long Island and the Hudson Valley in the NY State Department of Health's 2024 Managed Care Consumer Guide.

Do I need a referral to see an OB/GYN with EmblemHealth?

New York law gives managed care members direct access to an in-network OB/GYN for routine obstetric and gynecologic care. Referral rules for other specialists depend on your plan, so check your member handbook.

How do I confirm my EmblemHealth OB/GYN is in-network?

Log in to your EmblemHealth account, search the directory for the provider at the office you'll visit, then call both the office and member services. Ask for a reference number.

Sources

  • NY State Department of Health — Managed Care Regional Consumer Guide (health.data.ny.gov): HIP (EmblemHealth) and GHI (EmblemHealth)
  • EmblemHealth — Company history (GHI and HIP merger, 2006)
  • NY Department of Financial Services — Provider directory and continuity-of-care guidance
  • NY State Department of Health — Medicaid Perinatal Care Standards (2026)

This article is for general education and is not medical advice. It does not replace an evaluation by a licensed clinician who knows your history. If you think you have a medical emergency, call 911.