Do you need to make changes to your personal information? Elderplan can help while ensuring your privacy.

Make changes or written requests in four easy steps:

• Download the Member Information Update Form to update the following (requires Adobe Reader, free from Adobe Systems):
• Change of address
• Change Primary Care Physician (PCP)
• Get a new Elderplan member card (Reminder: While you DO NOT use your Medicare card for medical services, be sure to keep it in a safe place.)
• Print the form on your computer’s printer.
• Fill in the form completely, including your Elderplan member ID number.
• Mail or fax your form to the following address:
  Elderplan Member Service
  6323 Seventh Ave.
  Brooklyn, NY 11220
  Fax: (718) 630-2624

If you have any questions about changes you make to your personal information or any written requests, please don’t hesitate to contact Elderplan’s Member Services Department.