Elderplan Extra Help (HMO)
Offering quality Medicare benefits and extra help paying for health coverage
Making sure you receive the care you need is important to us. Making sure it’s affordable is important too. That’s why we designed a plan for Medicare beneficiaries which offers a little extra help in paying for your health coverage. You get the health care you need with a low premium and low co-pays.
In addition to medical and hospital coverage, our members who receive assistance from the Medicare Extra Help program or Low-Income Subsidy (LIS) will also experience additional savings on prescription drug coverage.
Plus, you will enjoy an OTC benefit, which includes health-related and select grocery items you can purchase at a store or order online, as well as home-delivered meals. The plan also provides comprehensive dental and transportation to medical appointments.
If by now it is not clear that our main goal is keeping you healthy and happy, you should also know we offer a Wellness Incentive program, which rewards you for receiving preventive screenings and immunizations. And because we care about your physical and mental well-being, we provide a fitness benefit (that allows you to join classes from home or work out at the gym) and the Brain HQ Memory Fitness Program.
The Elderplan Extra Help plan provides benefits like:
- No Part D deductible for preferred generic, generic, and preferred brand name drugs
- $0 co-pay for in-person or telehealth primary care visits
- Comprehensive dental, including fillings and crowns
- $150 for contacts or eyeglasses (lenses and frames) every year
- No-cost gym membership to help keep you fit and active, plus over 8,000 online videos1
- NEW! $0 for transportation to medical appointments — up to 8 one-way trips quarterly
- NEW! $60 every quarter for OTC + Grocery + Meals23
- NEW! BrainHQ® — a memory fitness program to improve brain function through games, puzzles, and other fun exercises
Prescription Drugs cost sharing is based on your level of Extra Help/LIS.
Available in the Bronx, Brooklyn, Manhattan, Queens and Westchester counties.
- No-cost gym membership is available at all fitness centers and select YMCAs in the Silver&Fit® network. [↩]
- For eligible members (with certain chronic conditions), the Special Supplemental Benefits for the Chronically Ill (grocery benefit) combines with the OTC benefit to cover certain grocery items and meals as a part of the monthly OTC allowance. [↩]
- Members in this plan receive a quarterly maximum amount ($60 every quarter) to purchase eligible OTC items at authorized retail stores. The OTC card balance cannot be carried over to the next quarter. The OTC card is not a debit or credit card and cannot be converted to cash. [↩]