Elderplan makes it easy to find the information you need.
Please use the links below to access helpful forms.
Member Information Update Form — Coming Soon
Member Reimbursement Form
Prescription Reimbursement Claim Form
Prescription Drug Mail Order Form
Redetermination of Prescription Drug Denial Form
Authorization for Release of Health Information
Request For Part D (Prescription Drug) Coverage
Medicare Electronic Complaint Form: English | Español
Appointing a Representative:
How to Appoint a Representative
Appointment of RepresentativeContact Member Services
If you are an Elderplan Member and have questions or concerns, please don’t hesitate to contact Elderplan Member Services at 1-800-353-3765 [TTY: 711], 8 a.m. to 8 p.m., seven days a week.
For additional information on how to get in touch with us, visit our Member Services Page.
Want to become an Elderplan member?
Call our Enrollment Call Center at
1-866-360-1934 [TTY: 711]
8 a.m. to 8 p.m., 7 days a week or enroll online.
Looking for information?
Questions? Call Elderplan today.
1-800-353-3765
[TTY: 711]
Hours of Operation:
8 a.m. to 8 p.m., 7 days a week
Elderplan is available in the Bronx, Dutchess, Kings, Monroe, Nassau, New York, Orange, Putnam, Queens, Richmond, Rockland, Suffolk, Westchester, Ontario, Orleans, Seneca, Yates, and Livingston counties.
