Simplify Your Health Care with Our Medicare and Medicaid Plans

All Your Benefits in One Simple Plan

If you have both Medicare and Medicaid, we offer health plans that combine all your benefits in one simple plan, making managing your health care needs easier. In addition to great benefits, you will receive support from a dedicated care manager who will help coordinate all your medical visits and care.

Elderplan for Medicaid Beneficiaries (HMO POS D-SNP)¹

This plan is ideal for dual Medicare and Medicaid beneficiaries who seek medical, hospital and prescription drug coverage all under one umbrella. With this plan, you’ll also have a dedicated care manager who will help you navigate your benefits, ensuring that you get the care and services you need to stay healthy and independent.

Some additional benefits include:

NEW! $660² per quarter for traditional OTC. Eligible members³ can also use their OTC allowance toward rent/mortgage plus utilities, internet, groceries, and meals.
NEW! No limit on supplemental comprehensive dental services, including crowns, dentures, implants, and root canals
Zero monthly plan premium
Zero copay for in-person or telehealth primary and specialist doctor visits
Freedom to choose any specialist or dentist in and out-of-network, giving you greater access to care
Zero copay on routine eye exam + up to [$350] for eyewear – every year
$500 Flex Card per year for out-of-pocket for dental, hearing, vision and fitness expenses

This plan is available in the Bronx, Manhattan, Queens, Brooklyn, Nassau, and Westchester counties.

Elderplan Plus Long-Term Care (HMO-POS D-SNP)⁴

An excellent choice for Medicare beneficiaries who qualify for Medicaid, require long-term care (LTC) services at home and prefer the ease and convenience of having their medical, hospital, prescription drug and LTC coverage in one simple plan. This plan provides a personal care worker (PCW) to help you with bathing, dressing and meals, plus support and attention from a Care Management Team. Your Care Management Team will contact your doctors to help develop a personalized plan of care, coordinate your medical services and help to arrange your appointments.

Some additional benefits include:

NEW! Community Rides. Eligible members³ can now use their OTC allowance toward transportation, including Uber and Lyft, to visit friends and family, pharmacies, grocery stores, houses of worship, senior centers and more.
NEW! $900⁵ per quarter for traditional OTC. Eligible³ members can also use their OTC allowance. toward rent/mortgage, utilities, internet, groceries, home-delivered meals and community rides.
NEW! $750 Flex card per year for out-of-pocket dental, hearing, vision and fitness expenses.
NEW! Zero copay for routine hearing exams + [$3,000] on hearing aids – every year.
Freedom to choose any specialist or dentist in or out-of-network, giving you greater access to care
NEW! Zero copay for routine hearing eye exams + [$600] on eyewear.
NEW! Worldwide emergency travel assistance services + up to $50,000 worldwide emergency coverage.

This plan is available in the Bronx, Manhattan, Queens, and Brooklyn, plus Dutchess, Orange, Putnam, Rockland, Richmond, Westchester and Nassau Counties. We are also happy to announce our expansion into Sullivan and Ulster Counties in 2025

Elderplan is an HMO plan with Medicare and Medicaid contracts. Enrollment in Elderplan depends on contract renewal. Elderplan/HomeFirst complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex.

ATTENTION: If you speak a non-English language or require assistance in ASL, language assistance services, free of charge, are available to you. Call 1-800-353-3765 (TTY: 711)

Elderplan/HomeFirst cumple con las leyes federales de derechos civiles aplicables y no discrimina por motivos de raza, color, nacionalidad, edad, discapacidad o sexo. ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 1-800-353-3765 (TTY: 711). Elderplan/HomeFirst 遵守適用的聯邦民權法律規定，不因種族、膚色、民族血統、年齡、殘障或性別而歧視任何人。注意：如果您使用繁體中文，您可以免費獲得語言援助服務。請致電 1-800-353-3765 [TTY: 711] 。

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1. Elderplan for Medicaid Beneficiaries is a dual eligible Special Needs Plan available to Medicare beneficiaries who receive New York State Medicaid or other assistance through New York State medical assistance programs. Premiums, copays, co-insurance, and deductibles may vary based on the level of Medicaid assistance and/or Low-Income Subsidy (LIS) (Extra Help) you may receive. Please get in touch with the Elderplan for further details.

2. Members in this plan receive a quarterly maximum of $660 to purchase eligible OTC items at authorized retail stores. The OTC card balance cannot be carried over to the next quarter; it is not a debit or credit card and cannot be converted to cash.

3. Eligibility is determined by whether you have a chronic condition associated with SSBCI benefit (expanded OTC). Examples of SSBCI conditions include but are not limited to, cardiovascular disorders, diabetes, arthritis, chronic lung disorders and cancer. There are other eligible conditions not listed. Standards may vary for this benefit.

4. Members eligible to enroll in this plan must have Medicare and Medicaid, be 18 or older, need community-based long-term care services for more than 120 days, and be assessed as a nursing home eligible.

5. Members in this plan receive a quarterly maximum of $900 to purchase eligible OTC items at authorized retail stores. The OTC card balance cannot be carried over to the next quarter; it is not a debit or credit card and cannot be converted to cash.

Elderplan es un plan HMO que tiene contratos con Medicare y Medicaid. La inscripción en Elderplan depende de la renovación del contrato.

Elderplan/HomeFirst complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. ATTENTION: If you speak a non-English language or require assistance in ASL, language assistance services, free of charge, are available to you. Call 1-800-353-3765 (TTY: 711). Elderplan/HomeFirst cumple con las leyes federales de derechos civiles aplicables y no discrimina por motivos de raza, color, nacionalidad, edad, discapacidad o sexo. ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 1-800-353-3765 (TTY: 711). Elderplan/HomeFirst 遵守適用的聯邦民權法律規定，不因種族、膚色、民族血統、年齡、殘障或性別而歧視任何人。注意：如果您使用繁體中文，您可以免費獲得語言援助服務。請致電 1-800-353-3765 [TTY: 711] 。

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1. Elderplan for Medicaid Beneficiaries es un plan de necesidades especiales de doble elegibilidad, disponible para los beneficiarios de Medicare que reciban asistencia de New York State Medicaid o de otros programas de asistencia médica del estado de New York. Es posible que las primas, los copagos, los coseguros y los deducibles varíen según el nivel de asistencia de Medicaid o el nivel de subsidio por bajos ingresos (LIS) (Ayuda adicional) que pueda recibir. Para obtener más detalles, póngase en contacto con Elderplan.

2. Los miembros de este plan reciben un máximo trimestral de $660 para comprar productos de venta libre (OTC) elegibles en tiendas minoristas autorizadas. El saldo de la tarjeta para OTC no se puede transferir al siguiente trimestre; no es una tarjeta de débito ni de crédito y no se puede canjear por efectivo.

3. La elegibilidad se determina en función de si usted tiene una afección crónica asociada con el beneficio suplementario especial para personas con enfermedades crónicas (SSBCI) (OTC ampliado). Los ejemplos de afecciones SSBCI incluyen, entre otros, trastornos cardiovasculares, diabetes, artritis, trastornos pulmonares crónicos y cáncer. Existen otras condiciones elegibles que no se enumeran. Los estándares pueden variar para este beneficio.

4. Los miembros elegibles para inscribirse en este plan deben tener Medicare y Medicaid, tener 18 años o más, necesitar servicios de atención a largo plazo basados en la comunidad por más de 120 días y haber sido evaluados como elegibles para un hogar de convalecencia.

Elderplan（長老計劃）是一項與 Medicare 聯邦醫療保險和 Medicaid 醫療補助簽有合約的 HMO 計劃。能否在 Elderplan（長老計劃）註冊參保視合約續簽情況而定。

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1. Medicaid 醫療補助受益人的長老計劃是一項雙重資格特殊需求計劃，適用於透過紐約州醫療援助計劃接受紐約州 Medicaid 醫療補助或其他援助的 Medicare 聯邦醫療保險受益人。保費、共付額、共同保險和自付額可能會根據您可能收到的 Medicaid 醫療補助援助和/或低收入補貼 (LIS)（「額外輔助」）的水平而有所不同。請聯絡 Elderplan（長老計劃）以了解更多詳情。

2. 該計劃的會員每季度最多可獲得 660 美元，用於在授權零售店購買符合條件的 OTC 藥品。 OTC 卡餘額無法結轉到下一季度；它不是借記卡或信用卡，也無法兌換成現金。

3. 資格取決於您是否患有與 SSBCI 福利（擴大的 OTC）相關的慢性病。 SSBCI 病症包括但不限於心血管疾病、糖尿病、關節炎、慢性肺部疾病和癌症。還有其他符合條件的疾病未列出。該福利的標準可能有所不同。

4. 有資格加入該計劃的會員必須享有 Medicare 聯邦醫療保險和 Medicaid 醫療補助，年滿 18 歲或以上，需要超過 120 天的社區長期護理服務，並被評估為符合療養院資格。

Simplify Your Health Care with Our Medicare and Medicaid Plans

All Your Benefits in One Simple Plan

Elderplan for Medicaid Beneficiaries (HMO POS D-SNP)1

Elderplan Plus Long-Term Care (HMO-POS D-SNP)4

Elderplan for Medicaid Beneficiaries (HMO POS D-SNP)¹

Elderplan Plus Long-Term Care (HMO-POS D-SNP)⁴