2024 Elderplan for Medicaid Beneficiaries (HMO POS D-SNP)
A health plan for Medicare Beneficiaries who also have Medicaid that offers extra benefits beyond the doctor’s office.1
- Medical, hospital and prescription drug benefits — all in one simple plan
- Ability to see any dentist or specialist at no extra cost
- Assistance with coordinating all your benefits with a dedicated care manager
- Available in the Bronx, New York, Queens, Kings, Nassau and Westchester counties
Benefits at a Glance
- NEW! $2,520 per year for expanded OTC. Now including rent/mortgage plus utilities, internet, groceries, home-delivered meals and traditional OTC.23
Learn more about our OTC benefits
- NEW! Freedom to choose any specialist or dentist you want at no extra cost (in and out-of network)
- NEW! $500 annual allowance for Flex Cards to help with out-of-pocket costs on dental, vision, and hearing benefits
- NEW! $0 copay for acupuncture, acupressure and reflexology visits — up to 20 visits per year
- Zero monthly plan premium4
- Zero co-pay for in-person or telehealth primary care and specialist doctor visits5
- Preventative and Comprehensive dental, including root canals and crowns
Learn more about dental benefits
- $350 for contacts or eyeglasses (lenses and frames) every year
- Zero-cost transportation to and from medical appointments
- Low co-pays for prescription drug coverage
- BrainHQ— a memory fitness program to improve brain function through games, puzzles and other fun exercises
Sign up for BrainHQ
- No-cost gym membership to help keep you fit and active, plus over 8,000 online videos6
Check out the Silver&Fit® network
- Dedicated Care Manager who will stay in touch with your doctors and help arrange your medical visits and transportation to get you there.
- Rewards for preventive screenings and immunizations through our Wellness Incentive program
Learn more about Wellness Incentive
- Membership in our award-winning Member-to-Member program
Learn more about Member-to-Member
- Worldwide emergency coverage up to $50,000
All cost sharing is based on your level of Medicaid eligibility.
Premiums, co-pays, co-insurance and deductibles may vary based on the level of Extra Help you receive. Please get in touch with the Elderplan for further details.
Explore our network
Our network includes over 40,000 Specialists, Primary Care Doctors, Pharmacies and Dentists!
- 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, co-pays, 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.
- Members in this Plan receive a monthly maximum amount (of $210 every month) to purchase eligible OTC items at authorized retail stores. Your OTC card balance cannot carry over to the next month. The OTC card is not a debit or credit card and cannot be converted to cash.
- The benefits mentioned are part of a special supplemental program for the chronically ill. Not all members qualify.
- You pay a $33.90 monthly plan premium; however, if you are eligible for Medicare cost-sharing assistance under Medicaid, you pay a $0 monthly plan premium.
- You pay 20% co-insurance for in-person office primary care and specialist doctor visits; however, if you are eligible for Medicare cost-sharing assistance under Medicaid, you pay 0% co-insurance. There is no co-insurance or co-payment for telehealth primary care services. You pay 20% co-insurance for telehealth specialist services; however, if you are eligible for Medicare cost-sharing assistance under Medicaid, you pay 0% co-insurance.
- No-cost gym membership is available at all fitness centers and select YMCAs in the Silver&Fit® network.