Member Materials

If you are an Elderplan FIDA Total Care (Medicare-Medicaid) participant, your participant materials are different. Please click here to review them.


For your convenience, you can now have your plan materials delivered straight to your door or email account via our secure Member Request Form. You also have the option to opt-in to receive all your materials electronically going forward. You will be asked to enter in 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.

Elderplan for Medicaid Beneficiaries (HMO SNP)

Elderplan Extra Help (HMO)

Elderplan Plus Long-Term Care (HMO SNP)

Elderplan Advantage for Nursing Home Residents (HMO SNP)

HomeFirst Managed Long-Term Care (MLTC) Plan

For HomeFirst plan materials, please click here.

Part C and D Star Rating

2018: English | Español

OVER-THE-COUNTER Pharmacy Benefit

To activate your OTC debit 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 for you 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 at 1-866-490-2102 or Member Services at 1-800-353-3765, or the TTY number for the hearing impaired, 711, seven days a week between the hours of 8:00 a.m. and 8:00 p.m.


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

2018 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 at 1-866-490-2102 or Member Services at 1-800-353-3765. The TTY number for the hearing impaired is 711. Member Services is available seven days a week between the hours of 8:00 a.m. and 8:00 p.m.


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

2018 Step Therapy List: English

Quantity Limits

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

 


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 formualry 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 (PBM) at 1-866-490-2102 or Member Services at 1-800-353-3765. The TTY number for the hearing impaired is 711. Member Services is available seven days a week between the hours of 8:00 a.m. and 8:00 p.m.

Notice of Privacy Practices: EnglishEspañol

Questions? Call Elderplan today.

1-800-353-3765

[TTY 711]

for the hearing impaired

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

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

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