For Medicare and Medicaid beneficiaries who need long-term care at home and want medical and drug coverage in the same plan.1
- Receive the care and support you need from the only 5-star MAP plan in New York State2
- Get assistance with coordinating all your benefits, including behavioral health services, from a dedicated care manager
- Enjoy expanded OTC benefits
- Available in the five boroughs of NYC, Nassau, Dutchess, Orange, Putnam, Rockland and Westchester Counties
Benefits at a Glance
NEW! $2,580 per year toward Over-the-Counter health-related items plus groceries, home-delivered meals, internet, wireless and utility bill pay34
Learn about our OTC benefits
Zero monthly plan premium
Zero co-pay for inpatient, in-network hospitalization
Zero co-pay for in-person or telehealth primary care and specialist doctor visits (no referrals required)
Preventive and Comprehensive dental, including root canals and crowns.
Learn more about our dental coverage.
Zero co-pay for routine hearing exams, hearing aid fittings and evaluations
Zero co-pay for routine eye exams. Glasses and medically necessary contacts every two years
Zero-cost transportation to and from medical appointments
NEW! Acupuncture– up to 28 visits per year
NEW! Podiatry – up to 12 visits per year
BrainHQ— a memory fitness program to improve brain function through games, puzzles and other fun exercises
Sign up for BrainHQ
Membership in our award-winning Member-to-Member program
Learn more about Member-to-Member
All cost sharing is based on your level of Medicaid eligibility.
Explore our network
Our network includes over 40,000 Specialists, Primary Care Doctors, Pharmacies and Dentists!
Interested in joining this plan?
To qualify for this plan, you must receive a health care assessment from one of our nurses.
To get started, please call our Enrollment Center at 1-866-360-1934 (TTY: 711).
Representatives are available to assist you 8 a.m. to 8 p.m., seven days a week.
- To be eligible for this plan, you must be 18 years or older, have Medicare and Medicaid, need community-based long-term care services for more than 120 days, and be assessed as nursing home eligible. [↩]
- Elderplan is the only 5-star plan in New York State (NYS) based on most recent 2019 data published in the DOH Consumer Guide Sept 2020 [↩]
- 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, home-delivered meals, internet, wireless and utility payments as part of the monthly OTC allowance. [↩]
- Members of this plan receive a monthly maximum amount (of $215 every month) to purchase eligible OTC items at authorized retail stores. Your OTC card balance cannot be carried over to the next month. The OTC card is not a debit or credit card and cannot be converted to cash. [↩]
