Elderly Couple Kissing on Bridge

“Elderplan gets us. That’s why we’ve got them.”

Welcome, Elderplan Members

At Elderplan, our members are also our neighbors. Whenever you need us, just give us a shout. We’ll do our best to help you stay healthy and get the most out of your benefits.

On this page, you’ll find the tools, resources and documents needed to help you get the most out of your Elderplan coverage and benefits. Whether you need to find a provider, learn if your prescription is covered in our formulary or review your coverage, it’s all here waiting for you.

And of course, any time you have questions or concerns, please don’t hesitate to contact Elderplan Member Services at 1-866-360-1934 [TTY: 711 for the hearing impaired], 8 a.m. to 8 p.m., 7 days a week.

Plan Materials

For your convenience, all plan materials are located on this website. However, if you prefer to have them emailed to you or mailed to your home, simply fill out the Secure Member Request Form below.

You will be asked to enter your Member ID number located at the back of your Member ID card. If you have trouble logging in, a Member Services representative will be happy to help you.

Secure Member Request Form:

Plan Material Request (English)
Plan Material Request (Español)

2021

Elderplan for Medicaid Beneficiaries (HMO D-SNP)

To activate your OTC card, to check your card balance or for a complete list of participating retailers, please visit OTC Network website: English | Español.

Elderplan Extra Help (HMO)

To activate your OTC card, to check your card balance or for a complete list of participating retailers, please visit OTC Network website: English | Español.

Elderplan Plus Long-Term Care (HMO D-SNP)

To activate your OTC card, to check your card balance or for a complete list of participating retailers, please visit OTC Network website: English | Español.

Elderplan Advantage for Nursing Home Residents (HMO I-SNP)

Elderplan Assist (HMO IE-SNP)

HomeFirst Managed Long-Term Care (MLTC) Plan

For HomeFirst plan materials, please click here.

2020

Elderplan for Medicaid Beneficiaries (HMO D-SNP)

Elderplan Extra Help (HMO)

Elderplan Plus Long-Term Care (HMO D-SNP)

Elderplan Advantage for Nursing Home Residents (HMO I-SNP)

Elderplan Assist (HMO IE-SNP)

HomeFirst Managed Long-Term Care (MLTC) Plan

For HomeFirst plan materials, please click here.

Part C and D Star Rating

Elderplan for Medicaid Beneficiaries (HMO D-SNP)
Elderplan Advantage for Nursing Home Residents (HMO I-SNP)
Elderplan Extra Help (HMO)
Elderplan Assist (HMO IE-SNP)

2021: English — Coming Soon | Español — Próximamente
2020: English | Español

Elderplan Plus Long-Term Care (HMO D-SNP)

2021: English — Coming Soon | Español — Próximamente
2020: English | Español

Over the Counter Benefit

To activate your OTC card, to check your card balance or for a complete list of participating retailers, please visit OTC Network website: English | Español.

Formulary Prior Authorization Approval Criteria

Certain drugs need authorization from Elderplan prior to dispensing at the pharmacy. Please click on the Prior Authorization Approval List link to see if you meet the criteria to receive authorization for your drug. You can also go to the Searchable Formulary to see if your drug needs prior authorization.

If you have any questions regarding Prior Authorizations, call our pharmacy benefit manager CVS/Caremark at 1-866-490-2102, (TTY users call 711) 24 hours a day, 7 days a week or Elderplan Member Services at 1-800-353-3765, (TTY users call 711) 7 days a week between the hours of 8 a.m. and 8 p.m.

Elderplan for Medicaid Beneficiaries (HMO D-SNP)
Elderplan Plus Long-Term Care (HMO D-SNP)
Elderplan Advantage for Nursing Home Residents (HMO I-SNP)

2021 Prior Authorization Approval List: English — Coming Soon
2020 Prior Authorization Approval List: English

Elderplan Extra Help (HMO)
Elderplan Assist (HMO IE-SNP)

2021 Prior Authorization Approval List: English — Coming Soon
2020 Prior Authorization Approval List: English

Step Therapy

Step Therapy is a key part of our prior authorization program that allows us to help your doctor provide you with an appropriate and affordable drug treatment. Before coverage is allowed, Elderplan requires you to first try certain drugs to treat your medical condition before we will cover another drug for that condition. For example, if Drug A and Drug B both treat your medical condition, Elderplan may not cover Drug B unless you try Drug A first. If Drug A does not work for you, Elderplan will then cover B. Please click on the Step Therapy Approval List to see if your drug requires Step Therapy. You can also go to the Searchable Formulary to see if your drug requires Step Therapy.

If you have any questions regarding Step Therapy, call our pharmacy benefit manager CVS/Caremark at 1-866-490-2102, (TTY users call 711) 24 hours a day, 7 days a week or Elderplan Member Services at 1-800-353-3765, (TTY users call 711) 7 days a week between the hours of 8 a.m. and 8 p.m.

Elderplan for Medicaid Beneficiaries (HMO D-SNP)
Elderplan Plus Long-Term Care (HMO D-SNP)
Elderplan Advantage for Nursing Home Residents (HMO I-SNP)

2021 Step Therapy List: English — Coming Soon
2020 Step Therapy List: English

Elderplan Extra Help (HMO)
Elderplan Assist (HMO IE-SNP)

2021 Step Therapy List: English — Coming Soon
2020 Step Therapy List: English

Quantity Limits

For certain drugs, Elderplan limits the amount of the drug that Elderplan will cover. For example, Elderplan provides 30 tablets per prescription for Pioglitazone. This may be in addition to a standard one-month or three-month supply. Please check our downloadable formulary or the searchable formulary link posted on our website to see if your drug has Quantity Limit restriction.

If you have any questions regarding Quantity Limits, call our pharmacy benefit manager CVS/Caremark at 1-866-490-2102, (TTY users call 711) 24 hours a day, 7 days a week or Elderplan Member Services at 1-800-353-3765, (TTY users call 711) 7 days a week between the hours of 8 a.m. and 8 p.m.

Our Wellness Partners

HealthPlex (Dental)

SuperiorVision (Vision)

HearUSA (Hearing)

LogistiCare (Transportation)

Notice of Privacy Practices: English | Español

Questions? Call Elderplan today.

1-866-360-1934

[TTY: 711]

for the hearing impaired

Hours of Operation:
8 a.m. to 8 p.m., 7 days a week

Elderplan is available
in the 5 boroughs of NYC,
Nassau, Suffolk, Westchester,
Rockland, Putnam, Monroe,
Dutchess and Orange counties.