Medicare Frequently Asked Questions
Who is eligible for Medicare?
- People who are 65 or older
- People under 65 with certain disabilities
- People with End-Stage Renal Disease (permanent kidney failure)
Do I need to sign up for Medicare before I turn 65?
Some people are automatically enrolled in Original Medicare (Part A and Part B) and other people have to sign up for it. In most cases, if you’re turning 65 and will be getting benefits from Social Security or the Railroad Retirement Board (RBB) at least 4 months before you turn 65, you will automatically get Medicare Part A and Part B starting the first day of the month you turn 65. If you’re under 65 and have a disability, you’ll automatically get Medicare Part A and Part B after you get disability benefits from Social Security or certain disability benefits from the RRB for 24 months. You don’t need to sign up if you automatically get Medicare Part A and Part B. You will get your Medicare card in the mail three months before your 65th birthday or 25th month of disability.
When can I join or switch my Medicare plan?
You can join or 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 health care 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 Enrollment Period: You can enroll three months before you turn 65 (or 25th month of disability), during your birthday month (or 25th month of disability) and up to three months after your birthday (or 25th of disability).
- Medicare Annual Enrollment Period (October 15-December 7): During this period, you can enroll in or switch plans, including adding or dropping prescription drug coverage or switch from a Medicare Advantage Plan back to Original Medicare. Your new coverage will start on January 1 of the following 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 Open Enrollment Period (January 1-March 31): During this time, you have a one-time opportunity to switch from one Medicare Advantage plan to a different one. You can also drop your current plan and return to Original Medicare with the option to purchase a stand-alone Medicare Part D Prescription Drug Plan.
What is MetroPlus Health Plan’s Contact Info?
MetroPlus Health Plan
50 Water Street, 7th Floor
New York, NY 10004
Phone: 1-866-986-0356, TTY users: 711
24 hours a day, 7 days a week
Fax: 1-212-908-8601
What if I miss an enrollment period?
Call us at 1.866.986.0356 (TTY users: 711), 24 hours a day, 7 days a week to speak with a representative for help. You can also 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.
Access to a doctor—whenever and wherever you need it!
MetroPlusHealth Virtual Visit is the fast, easy way for our members to see a provider for common physical, mental, emotional, and behavioral health issues that are not emergencies. MetroPlusHealth Virtual Visit is available anytime, from anywhere in New York State, 24/7 – and in your language.
GREAT NEWS: STARTING JANUARY 1, 2023, METROPLUSHEALTH MEMBERS WILL RECEIVE THEIR DENTAL BENEFITS FROM DENTAQUEST.
Know your rights and protections against surprise medical bills!
When you get emergency care or are treated by an out-of-network provider at an in-network hospital or ambulatory surgical center, you are protected from balance billing. In these cases, you shouldn’t be charged more than your plan’s copayments, coinsurance and/or deductible.
Are you receiving care at an NYC Health + Hospitals facility?
Manage Your Health Online With MyChart. Members who receive care at NYC Health + Hospital facilities now have access to MyChart. MyChart is a free secure portal you can use to manage your health information. MyChart allows you to:
- Message your primary care provider’s office
- Request refills of your prescription drugs
- Access your test results
- Schedule appointments
