Centers Plan for Dual Coverage Care (HMO D-SNP)
Centers Plan for Dual Coverage Care (HMO D-SNP) was designed to offer those who are eligible, the convenience of combining the benefits of both Medicare and Medicaid into one comprehensive health plan. The plan includes prescription drug coverage.
This section will provide you with all the information you need to get the most out of your Centers Plan for Dual Coverage Care benefits
D-SNP Frequently Asked Questions
D-SNP Eligibility Requirements / Plan Highlights 2025
D-SNP Eligibility Requirements/Plan Highlights 2025
Eligibility Requirements:
- You must be enrolled in Medicare Part A and B
- Be eligible for the New York State Medicaid Program – or – eligible for Medicare and Medicare cost-sharing assistance under Medicaid.
- You must live in our contracted service area (Bronx, Kings, Nassau, New York, Queens, Richmond and Rockland Counties)
- You are a United States citizen or are lawfully present in the United States.
Plan Highlights:
- $0 per month for Part C; and $72.30 per month for Part D Premium (If not paid for you by Medicaid or Extra Help).
- $250 monthly allowance for eligible Over the Counter (OTC) items. Please note: Unused amounts cannot be carried over from benefit period to benefit period. Please visit www.mybenefitscenter.com or call 1-833-684-8472 for a list of eligible OTC items and to check your card balance.
- Special Supplemental Benefits for the Chronically Ill (SSBCI), if you qualify. Please see the SSBCI Disclaimer for more information and eligibility criteria.
-
- Blood pressure monitor - Eligible members may receive a blood pressure monitor, once per year, based on medical necessity.
- Food & produce (i.e., frozen foods, canned foods, and produce) - Using the OTC debit card, eligible members may spend up to $250 every month on food & produce, utilities, and/or eligible OTC items.
- Utilities (electric, gas, heating oil, water, landline phone, or internet) - Using the OTC debit card, eligible members may spend up to $250 every month on food & produce, utilities, and/or eligible OTC items.
- Vision and Hearing services
- Transportation
- Prescription drug coverage
- Personal Care Manager
D-SNP Materials 2025
DSNP Important Member Forms
Important Member Forms
Member Reimbursement Form (last updated 10/2023)
How to Appoint a Representative - Last updated 03/07/19
In the event that you need to appoint a representative regarding a grievance, request a coverage determination or an appeal, or to make complaints, the following form is also available on the Medicare and Medicaid Services (CMS) website below:
CMS1696: Appointment of Representative | CMS
CMS Appointment of Representative Form – Last updated 11/2024
CMS Appointment of Representative Form_Spanish - Last updated 11/2024
CMS Appointment of Representative Form_Large Print - Last updated 11/2024
CMS Appointment of Representative Form Large Print Spanish - Last updated 11/2024
CMS Electronic Complaint Form – Last updated 11/19/2014
Best Available Evidence (BAE) – Last updated 11/19/2014
D-SNP Find a Provider
Prescription Drugs Search Tools
For Prospective Members: Drug Pricing & Pharmacy Search Tool
Drug Pricing quotes do not take into account Low Income Subsidy level. If you qualify for Low Income Subsidy, your actual prescription drug copay may be less.
For Current Members: Prescription Drugs Member Portal – Real Time Benefits Tool
Register for the Member Portal to have access to personalized drug pricing, savings suggestions & calculator, pharmacy network search, drug side effects information, pill identifier, drug-drug interactions check, your prior authorizations and drug claims history, Medicare prescription payment plan portal, tax reports and more
For any pharmacy-related and medication-related benefit questions or to request a prior authorization or a coverage determination, call toll-free 1-888-807-5717 (TTY users call 711) 24 hours a day, 7 days a week or email: customerservice@medimpact.com
Medication Therapy Management (MTM)
If you have complex health needs, you may be able to participate in a Medication Therapy Management (MTM) program. MTM is a service offered by Centers Plan for Healthy Living at no additional cost to you! This program helps you and your doctor make sure that your medications are working well. It also helps us identify and reduce possible medication problems. To find out more please click here.
Personalized Medication List - English
Personalized Medication List – Spanish
For any pharmacy-related and medication-related benefit questions or to request a prior authorization or a coverage determination, call toll-free 1-888-807-5717 (TTY users call 711) 24 hours a day, 7 days a week or email: customerservice@medimpact.com
Prescription Drugs Benefits Overview
Prescription Drugs Benefits Overview
Prescription Drugs Member Portal – Real Time Benefits Tool
Part D Coverage Determination Form
Request for Redetermination of Medicare Prescription Drug Denial form
Prescription Drug Transition Policy
Prescription Drug Reimbursement Claim Form
For any pharmacy-related and medication-related benefit questions or to request a prior authorization or a coverage determination, call toll-free 1-888-807-5717 (TTY users call 711) 24 hours a day, 7 days a week or email: customerservice@medimpact.com
Medicare Prescription Payment Plan
Medicare Prescription Payment Plan (MPPP)
The Medicare Prescription Payment Plan is a voluntary payment option that works with your current drug coverage to help you manage your out-of-pocket Medicare Part D drug costs by spreading them across the calendar year (January-December). This payment option might help you manage your expenses, but it doesn’t save you money or lower your drug costs.
This payment option might not be the best choice for you if you get help paying for your prescription drug costs through programs like Extra Help from Medicare or EPIC (New York’s State Pharmaceutical Assistance Program/SPAP for short). Call us at 1-888-807-5717 (TTY 711), 24 hours a day, 7 days a week for more information.
For more information see the Medicare Prescription Payment Plan Fact Sheet
Think this program might be a good fit for you?
There are three ways to enroll:
|
Enroll by Phone: |
Call us at 1-888-807-5717 (TTY 711), 24 hours a day, 7 days a week
|
|
Enroll Online: |
Visit mp.medimpact.com (our prescription drug member portal) Instructions for Filling Out Online Medicare Prescription Payment Plan Request to Opt-in |
|
Enroll by Mail:
|
Medicare Prescription Payment Plan Participation Request Form |
Rights and Responsibilities Upon Disenrollment
For information on your and Centers Plans’ rights and responsibilities upon your disenrollment from our plan, please see Chapter 10 of the Evidence of Coverage (EOC).
D-SNP Service Areas
- Centers Plan for Dual Coverage Care serves the following 7 counties in New York State:
- Bronx
- Kings (Brooklyn)
- Nassau
- New York (Manhattan)
- Queens
- Richmond (Staten Island)
- Rockland counties
H6988_CY25_Website_M