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
- Ability to see any dentist or specialist at no extra cost
- Available in the five boroughs of NYC, Nassau, Dutchess, Orange, Putnam, Rockland and Westchester Counties
Benefits at a Glance
NEW! $3,240 per year toward Over-the-Counter health-related items plus rent/mortgage, groceries, home-delivered meals, internet, wireless and utility bill pay34
Learn about our OTC benefits
NEW! $500 annual allowance for Flex Cards to help with out-of-pocket costs for dental, vision, and hearing
NEW! Freedom to choose any specialist or dentist at no extra cost (in- and out-of-network)5
NEW! $0 copay for acupuncture, acupressure and reflexology visits — up to 28 visits per year
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 evaluations6
Zero co-pay for one routine eye exam every year
Zero-cost transportation to and from medical appointments
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
Wellness Incentive program, which rewards you for receiving preventive screenings and immunizations
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.
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.
Did you know that now even more people qualify for Medicaid?
Learn more about Medicaid Spend-down and Medically Needy Income Level (MNIL) in New York State.
Download plan details (PDF)
- 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). This is the highest rating a plan can receive. Based on the most recent results published in the DOH Consumer Guide in October 2023. [↩]
- Members of this plan receive a monthly maximum amount (of $270 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. [↩]
- The benefits mentioned are a part of 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. [↩]
- Hearing exams are covered once a year. Hearing aids and evaluation is covered once every three years. [↩]
