Frequently Asked Questions

Who is eligible for Medicare?

  • Reach age 65 and are entitled to monthly Social Security benefits.
  • Are age 65 or over and have a spouse entitled to Social Security benefits, even if you are not.
  • Are age 65 or over and are the widow or widower of someone who was entitled to Social Security benefits.
  • Are under age 65 and have received Social Security disability benefits for at least 24 months.
  • Are entitled to Social Security benefits and need maintenance kidney dialysis or a kidney transplant, regardless of your age.

Do I need to sign up for Medicare before I turn 65?

Most people are automatically enrolled in Original Medicare (Parts A and B). If you’re turning 65 or disabled and qualify for Social Security or Railroad Retirement Board (RBB) benefits, Medicare will enroll you. You will get your Medicare card in the mail three months before your 65th birthday or in your 25th month of disability.

When can I join or switch my Medicare plan?

You can switch plans during certain times of the year. Since your health and finances may change from year to year, it’s smart to review your healthcare needs every year to see if you need to change to a plan that works better for your current needs. You can join or switch plans during the following times:
 
  • Initial Coverage Election Period: You can enroll three months before you turn 65, during your birthday month (or 25th month of disability) and up to three months after your birthday (for Medicare Prescription Drug Plans and Medicare Advantage Plans).
  • Annual Open Enrollment Period: For 2017 Medicare coverage, open enrollment is in the fall of 2016, from October 15 to December 7. You can enroll in or switch plans, including adding or dropping prescription drug coverage. Your new coverage will start on January 1 of the next year. 
  • Special Election Period: If you qualify for Medicaid, Extra Help or meet other special circumstances, you may be eligible for this period. If you are eligible you can add new coverage or make changes to your current coverage depending on your situation
  • Medicare Advantage Disenrollment Period (MADP) (January 1 to February 14): If you’re enrolled in a Medicare Advantage Plan you have 45 days to drop your plan and choose a prescription drug plan (Part D). You can only return to Original Medicare during this time period. It may be possible to switch plans at other times than those listed here.

What if I miss an enrollment period?

Call Medicare directly at 1.800.MEDICARE or 1.800.633.4227. TTY users: 1.877.486.2048. Explain your circumstances to a representative. It may be possible to switch plans at other times, depending on your situation. 
  
What is MetroPlus Health Plan's Contact Info? 
 
MetroPlus Health Plan
160 Water Street, 3rd Floor
New York, NY 10038
Fax: 1.212.908.8601

Monday through Saturday, 8 am - 8 pm
1.866.986.0356
TTY users: 711

After hours, Sunday & Holidays, 24/7 Medical Answering Services: 1.800.422.2560

The MetroPlus Health Plan Medicare website is www.MetroPlusMedicare.org.