A health plan designed specifically for beneficiaries who are eligible for Extra Help (LIS)1.
- For Medicare beneficiaries
- Get your medical, hospital, prescription drug coverage and more at little- or-no premium and with low copays
- Provides additional benefits to help you stay healthy, like gym membership, wellness incentives, and access to Member-to-Member program
- Available in the Bronx, Manhattan, Queens and Brooklyn
Benefits at a Glance
OTC: $1402quarterly towards Traditional OTC. Eligible members3 can also use allowance toward Expanded OTC benefits for groceries or home-delivered meals
Flex Card: $500 allowance per year for out-of-pocket dental, hearing, vision and fitness expenses
Learn more about the new Flex benefit
Primary Care: Zero copay for in-person or telehealth primary care visits
Specialists: Freedom to choose any specialist, giving you greater access to care
Prescription Drugs: Zero deductible for preferred generic, generic and preferred brand drugs
Dental: Includes preventative and comprehensive care, including root canals and crowns
Transportation: Zero cost transportation to and from medical appointments– up to 32 one-way trips
NEW increased for 2025! Vision: Zero copay for routine eye exams + $200 on eyewear like contacts or eyeglasses, including lenses and frames – every year
NEW expanded for 2025! Travel Assistance: Zero copay for worldwide emergency coverage + travel assistance services
Acupuncture: Zero copay on acupuncture, acupressure and reflexology visits — up to 20 visits per year 
Gym Membership: No-cost gym membership to help keep you fit and active, plus over 15,000 online videos4
Wellness Incentives: Earn rewards for doing preventative screenings and immunizations through our Wellness Incentive Program
BrainHQ: Improve brain function through a memory fitness program with games, puzzles and other fun exercises
Sign up for BrainHQ
Prescription Drug cost sharing is based on your Extra Help/LIS level.
Explore our network
Our network includes over 40,000 Specialists, Primary Care Doctors, Pharmacies and Dentists!
Interested in joining this plan?
Online enrollment begins October 15.
Or call 1-866-360-1934 8 a.m. to 8 p.m., seven days a week (TTY: 711)
Download plan details (PDF)
- To determine eligibility for Extra Help from Social Security, you will need information about your (and your spouse’s) income and resources. For more information about qualifying for Extra Help, visit the Social Security website.[↩]
- The OTC card is not a debit or credit card and cannot be converted to cash.[↩]
- Eligibility is determined by whether you have a chronic condition associated with SSBCI benefit (expanded OTC). Examples of SSBCI conditions include but are not limited to, Cardiovascular Disorders, Diabetes, Arthritis, Chronic Lung Disorders and Cancer. There are other eligible conditions not listed. Standards may vary for this benefit.[↩]
- No-cost gym membership is available at all fitness centers and select YMCAs in the Silver&Fit® network.[↩]
