Frequently Asked Questions

1. When will my benefits go into effect?
2. What if I don’t have my Centers Plan for Healthy Living member card yet and I need to see my doctor?
3. I have a Medicare ID card, what should I do with it?
4. How do I pay my monthly premium?
5. If am moving, what should I do?
6. I lost my wallet and my Member ID card and the OTC card were in my wallet, what should I do?
7. What is a Primary Care Physician (PCP)?
8. Can I change my Primary Care Physician?
9. Can I get care from a specialist?
10. Can I get a second opinion?

• When will my benefits go into effect?
  Generally, your benefits will go into effect the first day of the month immediately following the month you enrolled. For instance, if you join in December, your Centers Plan for Medicare Advantage Care benefits become effective on January 1.You can also reach our Member Services and confirm your enrollment effective date by calling 1-877-940-9330, or for TTY users call 711, from 8 am to 8pm seven days a week.

• What if I don’t have my Centers Plan for Healthy Living member card yet and I need to see my doctor?
  If you need to see your doctor before your member ID card has arrived, we can help your doctor confirm your effective date of enrollment. Just call Member Services at 1-877-940-9330, TTY users call 711, from 8 am to 8pm seven days a week, and they will gladly help you.

• I have a Medicare ID card, what should I do with it?
  Centers Plan for Medicare Advantage Care has a contract with Medicare to provide the health benefits you need. In order to get your medical and prescription benefits, you will need to use your Centers Plan for Medicare Advantage Care member ID card. No need to worry, you are still part of Medicare, only now you will be receiving expanded benefits from Centers Plan for Medicare Advantage Care.
  IT IS VERY IMPORTANT THAT DO NOT USE YOUR MEDICARE CARD. Keep your Medicare card in a safe place where you can find it.Once your Center’s Plan enrollment becomes effective all you need is your new Centers Plan for Medicare Advantage Care member ID card.If you did not get or need a replacement for your Centers Plan for Medicare Advantage Care member ID card or have any questions, please contact Member Services 1-877-940-9330, TTY users call 711, from 8 am to 8pm seven days a week, and one of or friendly representatives will help you.

• How do I pay my monthly premium?
  As a member of Centers Plan for Medicare Advantage Care you do not have a plan premium. All you have to do is continue paying your Part B premium, if not paid by Medicaid. For more information, call our Member Services 1-877-940-9330, TTY users call 711, from 8 am to 8pm seven days a week.

• I am moving, what should I do?
  Our service area includes the following counties: Bronx, Erie, Kings (Brooklyn), New York (Manhattan), Niagara, Queens, Richmond (Staten Island) & Rockland. If you are moving out of the service area you need to contact us and tell us of the details of the move. You can contact the Customer Care Group 1-877-940-9330, TTY users call 711, from 8 am to 8pm seven days a week.

• I lost my wallet and my Member ID card and the OTC card were in my wallet, what should I do?
  Should you either lose or misplace any of your cards, it is important that you call us as soon as possible so that we can update your records and request replacements as soon as possible. Call Member Services at 1-877-940-9330, TTY users call 711, from 8 am to 8pm seven days a week, and one of our friendly representative will be more than glad to help you. We are only a phone call away!

• What is a Primary Care Physician (PCP)?
  Primary Care Physicians, also known as PCPs, are doctors providing basic healthcare services. Your PCPs can be a:

   

  • Internal Medicine Physician
  • Family Practice Physicians
  • General Practice Physician
  • Pediatrician
  • Sometimes, Obstetrician/Gynecologists

  When you become a member of Centers Plan for Medicare Advantage Care, you must select a plan physician as your PCP. As a Physician, your PCP meets state requirements and is trained to give you basic medical care. For your convenience, your routine healthcare care will be provided by Primary Care Physician, who will also coordinate the rest of your benefits and services for which you are covered a member of Centers Plan for Healthy Living.

  If you need to search for a PCP or other provider, call our Member Services 1-877-940-9330, TTY users call 711, from 8 am to 8pm seven days a week, and request an updated list or if you prefer you can search on our website at centersplan.com

• Can I change my Primary Care Physician?
  You can change your Primary Care Physician to another physician within the Centers Plan for Healthy Living network at any time. You can change your Primary Care Physician by either:

   

  • Calling Member Services and speak with one of our friendly representative, 1-877-940-9330, TTY users call 711, from 8 am to 8pm seven days a week.
  • Or, if it is more convenient for you, you can mail your request for a new PCP to:

  Centers Plan for Healthy Living
  Member Services
  75 Vanderbilt Avenue
  Staten Island, NY 10304

  Either way, once we process your request, we will send you a new Centers Plan for Healthy Living member ID card.

• Can I get care from a specialist?
  You definitely can get care from a specialist. However, in order for Centers Plan to cover a specialist visit you must see a specialist participating in the Centers Plan network. You may also need prior authorization from Centers Plan before receiving certain types of care. When this happens, your PCP will contact Centers Plan and let you know when authorization is given. The best part is that you do not need a referral from your PCP in order to see a specialist.

• Can I get a second opinion?
  You can get a second opinion. However, you must first contact your primary care physician, who will request Centers Plan to authorize the additional doctor’s visit. You will need to pay any applicable co-payment for a specialist visit when you go for your second opinion.

Medicare Disclaimer

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