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
- 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. 2 3
Learn more about our OTC benefits
NEW! Freedom to choose any specialist you want at no extra cost (in and out-of network)
NEW! Freedom to choose any dentist (in or out-of-network) 4
NEW! $500 annual allowance for Flex Cards to help with out-of-pocket costs on dental, vision, and hearing benefits
Learn more about the new Flex benefit
NEW! $0 copay for acupuncture, acupressure and reflexology visits — up to 20 visits per year
Zero monthly plan premium 5
Zero co-pay for in-person or telehealth primary care and specialist doctor visits 6
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 videos 7
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!
Interested in joining this plan?
Or 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.
Did you know that now even more people qualify for Medicaid?
Because Medicaid is designed for low-income families, income limits apply. Income limits are set by the federal government as a percentage of the federal poverty level (FPL). Learn more about Medicaid Spend-down and Medically Needy Income Level (MNIL) in New York State.
Download plan details (PDF)
- 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.[↩]
- Out-of-network/non-contracted providers are under no obligation to treat Plan members, except in emergency situations. Please call our Member Services number or see your Evidence of Coverage for more information, including the cost-sharing that applies to out-of-network services.[↩]
- 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.[↩]
