Elderplan is a (HMO) plan with Medicare and Medicaid contracts. Enrollment in Elderplan depends on contract renewal. Individuals must have both Part A and Part B to enroll. You must continue to pay your Medicare Part B premium if not otherwise paid for by Medicaid.
Members must receive all routine care from plan providers.
Benefits, premiums, and /or co-payments/co-insurance may change on January 1 of each year. The formulary, pharmacy network, and/or provider network may change at any time. You will receive notice when necessary.
Authorization rules may apply for certain services. Limitations, copayments and restrictions may apply. Members may enroll in Elderplan only during specific times of the year. Dual eligible members may enroll all year round. Contact Elderplan for more information. Plan materials are available in alternative formats or languages. Please call Elderplan’s Member Services Department at 1-800-353-3765 (TTY 711 for the hearing impaired), between 8 a.m. – 8 p.m., 7 days a week, to request materials in alternate formats.
Esta información puede estar disponible en diferentes idiomas o formatos. Favor de llamar al 1-800-353-3765 (TTY 711) de 8:00 a.m. a 8:00 p.m., 7 dias a la semana. Si necesita obtener información en otro formato o idioma, comuníquese con el Servicio de Atención al Cliente al número mencionado anteriormente.
Elderplan has been approved by the National Committee for Quality Assurance (NCQA) to operate as a Special Needs Plan (SNP) until 12.31.2017 based on a review of Elderplan’s model of care.
Elderplan’s pharmacy network includes retail, mail order, long-term care and home infusion pharmacies. For mail order information and additional information about network pharmacies, contact Elderplan’s Member Services Department at 1-800-353-3765 (TTY 711 for the hearing impaired), between 8 a.m. – 8 p.m., 7 days a week. Information may also be obtained by writing Elderplan, Attention: Member Service Department, 6323 Seventh Ave., 3rd Floor, Brooklyn, NY 11220-4711.
In general, beneficiaries must use network pharmacies to access their prescription drug benefit, except in non-routine circumstances, and quantity limitations and restrictions may apply.
Medicare beneficiaries may also enroll in Elderplan through the CMS Medicare Online Enrollment Center located at http://www.medicare.gov.
You may be able to get Extra Help to pay for your prescription drug premiums and costs. To see if you qualify for Extra Help, call:
- 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048, 24 hours a day/7 days a week;
- The Social Security Office at 1-800-772-1213 between 7 a.m. and 7 p.m., Monday through Friday. TTY users should call 1-877-486-2048; or
- Your State Medicaid Office