Medicare 2025

Need someone to help with your healthcare decisions?

You can appoint someone you trust to act on your behalf for:

• Coverage decisions
• Benefit requests
• Appeals
• Other healthcare matters

Get started by following these simple steps:

1. Download and complete the Appointment of Representative form:
   • English version
   • Spanish version
2. Both you and your chosen representative must sign the form.
3. Submit the completed form:
   • Fax to: 1-212-908-8701
   • Or mail to: [ADDRESS]

Important note: Some individuals may already be legally authorized to act as your representative under State law. The form is still required to confirm this relationship with MetroPlusHealth.

You may qualify for additional medical benefits through Medicare if you:

• Are turning 65 within the next 3 months
• Are already 65 or older

Note for Medicaid recipients: You MUST apply for Medicare to maintain your eligibility.

How to apply for Medicare:

• Call Social Security: 1-800-772-1213
• Or apply online: ssa.gov/medicare/
• Keep your confirmation (award letter, denial letter, or online receipt) as proof of application.

Questions?

• Learn more about applying to Medicare here.
• Contact Member Services: 833-965-1526 (TTY: 711).

Important Medication Safety Update: Medicare Part D plans have implemented new strategies to prevent opioid overuse, including additional safety alerts when prescriptions are filled.
Get the details.

Updated May 2025

Updated May 2025

Updated May 2025

Submitting Your Medicare Forms

Send all completed Medicare forms to:

MetroPlusHealth Plan
50 Water Street, 7th Floor
New York, NY 10004
Attention: Sales & Marketing Department

Important reminder: Please ensure all forms are fully completed before sending.

Request Hard Copy Materials

Need printed copies mailed to you?

• Provider/Pharmacy Directory
• Evidence of Coverage (EOC)

How to request:

1. Sign in to your member portal account (or create a new one).
2. Request hard copies through your account.
3. Or call 866.986.0356 (TTY: 711)
   • Monday-Friday: 8am-8pm
   • Saturday: 9am-5pm
   • After hours: 800.442.2560 (free call)
4. Or complete our online Contact form.

Digital access is always available:
Provider Directory: Visit our Provider Directory page.
Evidence of Coverage for your plan

Medicare Support:

• Medicare information and assistance
• Identity protection and Medicare card security
• Medicare.gov Ombudsman services

For Seniors:

• Virtual programming for older adults and caregivers
• NYC Department for the Aging resources
• Find MetroPlusHealth representatives near you

Important Documents:

• Medicare Star Ratings: English | Español | 中文
• Multi-Language Interpreter Services (PDF)
• MetroPlusHealth Privacy Notice
• MetroPlusHealth Disaster Information Policy (PDF)

Manage Your Health Online with MyChart

Are you a patient at an NYC Health + Hospitals facility?
You can now access MyChart—a secure online portal at no additional cost that lets you manage your health information in one place.
With MyChart, you can:

• Message your primary care provider
• Request prescription refills
• View your test results
• Schedule appointments

Get started: Visit nychealthandhospitals.org/mychart/ to sign up today.

Legal Information: MetroPlus Health Plan, Inc. is an HMO, HMO D-SNP plan with a Medicare contract. MetroPlus Health Plan has a contract with New York State Medicaid for MetroPlus UltraCare (HMO D-SNP) and a Coordination of Benefits Agreement with the New York State Department of Health for the MetroPlus Advantage Plan (HMO D-SNP). Enrollment depends on contract renewal.

MetroPlusHealth is not affiliated with the federal government, CMS, HHS, and/or Medicare.

Language Assistance:

English: 866.986.0356 (TTY: 711)
Español: 866.986.0356 (TTY: 711)
中文: 866.986.0356 (TTY: 711)

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