What to Expect as an Elderplan Member
Thinking about joining Elderplan? Or did you just sign up? Either way, this guide tells you what to expect.
Joining a new plan is a big step. We want it to feel simple. And if you are helping someone you love, this guide can help you know what happens next for them, too.
Your welcome
After you join, you will get a welcome packet and a member ID card in the mail. Keep your card in a safe, easy-to-reach spot. You will show it when you see a doctor or pick up medicine.
If your card does not come, or you lose it, call us. We will send you a new one.
Your care manager
As a member, you can have a care manager. This is your main contact at the plan.
Your care manager helps you:
- Understand your benefits
- Find doctors and set up visits
- Get the services and care you need
Think of your care manager as your guide. If you are not sure what to do, you can always start with them.
Keeping or choosing your doctors
Many people want to keep the doctors they already know. Often, you can.
If your doctors work with Elderplan, you can keep seeing them. To find out, check your plan's provider directory or call us.
When you first join, we work with you to set up your care. During this time, you can usually keep seeing your current doctors for a while — for example, up to 90 days, or until your care plan is ready. Ask us how this works for your plan.
Need a new doctor? Your plan's provider directory lists doctors you can choose from. We can help you pick one.
Your prescriptions
If your plan includes drug coverage, it helps pay for your medicine.
Fill your prescriptions at a pharmacy that works with your plan. Your plan's pharmacy directory shows you where to go.
Is one of your drugs not covered? Do not worry. You may be able to get a short supply while we help you switch to a covered drug or ask for an exception. Just call us.
Extra benefits
Depending on your plan, you may have extra benefits beyond your regular medical care. These can include things like:
- An allowance for over-the-counter items, such as vitamins and first-aid supplies
- Rides to your medical visits
Every plan is different. To see what your plan offers, read your plan's Summary of Benefits, or call us, and we will explain it.
Getting help
You are never on your own. Our Member Services team is here for you.
- Have a question? Call the number on your member ID card.
- Need help in another language? We offer free help in other languages.
- Need materials in large print, braille, or audio? We can provide these at no cost.
What you pay
What you pay depends on your plan. Many members pay little or nothing for covered care. To see the exact costs, read your plan's Summary of Benefits.
Good to know
This guide gives you a simple overview. Benefits and rules are different for each plan. For full details, read your plan's Evidence of Coverage and Summary of Benefits. If anything here is different from those documents, those documents are correct.