Elderplan Plus Long-Term Care (HMO D-SNP)

Elderplan offers the only 5-Star MAP plan in New York State (covers: Medicare, Medicaid, Long-Term Care & Prescription Drugs) as published in the DOH Consumer Guide September 2020

Now more than ever people want the ability to receive the care they need in the safety and comfort of their own home. This plan was designed for Medicare and Medicaid beneficiaries who need valuable assistance with long-term care at home.

You’ll be happy to know that there is no plan premium, no co-payments for doctor and hospital visits, and low co-payments for prescription drugs. Plus, you will enjoy an over-the-counter (OTC) benefit which now includes both health-related and select grocery items, and transportation to medical appointments.

Perhaps one of the biggest perks of being enrolled in this plan, is that you are assigned a dedicated Care Manager who leads a team of caring clinical professionals all committed to helping you stay healthy. Your Care Manager will stay in touch with your doctors, helping arrange your medical visits as well as transportation to get you there. They will be your go-to person and will work to help ensure you get the care you need to remain safely at home. Additionally, a registered nurse will visit you periodically to check on you and assess your needs.

And when it comes to who provides your care at home, you have choices. We will be happy to provide a Home Health Aide who will assist you with activities such as bathing, dressing and preparing meals. But if you prefer it be someone you already know, we understand. You can pick a friend, neighbor, or in some cases, a family member to take care of you through the Consumer Directed Personal Assistance Services (CDPAS) program and they will be paid for their time.

The Elderplan Plus Long-Term Care1  plan provides benefits like:

  • $0 monthly plan premium
  • $0 for inpatient, in-network hospitalization
  • $160 every month for over-the-counter (OTC), health-related items23
  • NEW! Use your OTC benefit to purchase groceries, too!23
  • $0 co-pay for in-person or telehealth primary care and specialist doctor visits

All cost sharing is based on your level of Medicaid eligibility.

Available in the 5 boroughs of NYC, Nassau, Westchester, Putnam, Rockland, Dutchess and Orange counties.

If interested in joining this plan, please call our Enrollment Center at 1-866-360-1934 [TTY: 711 for the hearing impaired]. Representatives are available to assist you 8 a.m. to 8 p.m., 7 days a week.

Long-Term Care

Want to learn more about everything Elderplan Plus Long-Term Care (HMO D-SNP) has to offer?
Click on the links below to read more.

  1. To be eligible for this plan, adults must be 18 years of age or older, must have Medicare and Medicaid, and need community based long-term care services for more than 120 days and assessed as nursing home eligible. []
  2. 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 as a part of the monthly OTC allowance. [] []
  3. Members in this plan receive a monthly maximum amount ($160 every month) to purchase eligible over-the-counter (OTC) items at authorized retail stores. The 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. [] []