For New Members
- When will my benefits go into effect?
- What if I need to see a doctor and I don’t have my Elderplan member card yet?
- What do I do with my Medicare card?
- What if I have Medicare and Medicaid?
- Potential for Possible Contract Termination?
When will my benefits go into effect?
Most of the time, your benefits will go into effect the first day of the month immediately following the month you joined. For example, if you join in March, your Elderplan benefits will start April 1.
To verify your enrollment effective date, please call Member Services at 1-800-353-3765, or the TTY number for the hearing impaired, 1-800-662-1220, available seven days a week, between the hours of 8:00 a.m. and 8:00 p.m.
What if I need to see a doctor and I don’t have my Elderplan member card yet?
Call Member Services! We can help your doctor confirm your benefits if you need medical care and your Elderplan coverage has started, but your card has not arrived.
What do I do with my Medicare card?
Elderplan has a contract with Medicare to provide you with all of your health benefits. That means you should use Elderplan’s member card for your doctor visits, hospitalization, prescriptions and other medical services. Don’t worry, you are still part of Medicare, but now you receive expanded benefits with Elderplan.
DO NOT USE YOUR MEDICARE CARD. Put your Medicare card in a safe place where you can find it. Do not throw it away.
From now on, your Elderplan member card is the card you need.
Contact Member Services if you did not get an Elderplan member card or if you need a replacement card.
What if I have Medicare and Medicaid?
You can have Medicare and Medicaid and be an Elderplan member. Here are some important facts to keep in mind:
- As a member, it is your responsibility to assist Elderplan in preparing any required re-certification documents as they are due.
- For some Elderplan plans, we manage a portion of your Medicaid benefits while the remaining Medicaid benefits are covered under fee-for-service (FFS) Medicaid. Please refer to your Evidence of Coverage for details on how to access your Medicaid benefits and what cards you need to show when you receive service.
- Depending on your plan, providers will either bill FFS Medicaid or Elderplan for Medicaid covered services or cost shares. In order to bill FFS Medicaid for services or cost shares, providers must participate in the Medicaid program with New York State.
- Elderplan Providers who participate in the Medicaid program with NY State will bill Medicaid directly for any applicable Medicaid cost shares depending on the plan. Elderplan providers may bill Elderplan directly for other covered services or may bill Elderplan directly for the entire Medicaid amount depending on the plan.
- You will pay discounted rates for prescription medications if you have both Medicare and Medicaid. These discounts will apply throughout the entirety of your Part D prescription benefit.
Potential for Possible Contract Termination?
If Elderplan leaves the Medicare program, by contract termination, or is no longer available in your area because of a service area reduction, we will provide you with a termination notice or plan change notice, well in advance. This notice will provide information about Medicare coverage options available to you because of the plan change, including guaranteed Medigap rights.
Whether leaving the plan is your choice or not, you can find more information about your Medicare choices after you leave and the rules that apply in the Evidence of Coverage.
