Empire Senior Plan Direct Plus  is available to Medicare-eligible residents of the Bronx, Kings, Nassau, New York, Queens, Richmond, Rockland, Suffolk, and Westchester counties.

With Senior Plan Direct Plus*, you will receive all the coverage provided by Medicare and most Medicare supplement plans combined, plus important extra coverage such as: 

• No deductibles or coinsurance and no referral necessary to see a specialist 
• $25 co-payment for Mental Health visits in all areas 
• $50 co-payment for Emergency room visits in all areas 
• Free eyeglasses once every 24 months**
• Free hearing exam once every 12 months
• $1,000 towards 2 hearing aids once every 36 months 
• Silver Sneakers, free membership to a participating gym 
• Empire Healthline , a toll-free health information hotline available to members 24 hours a day, 7 days a week
  

When traveling outside the area, urgent and emergency care is covered.  You can be away up to 6 consecutive months.

Prescription Drugs
Retirees who receive prescription drug coverage through their union welfare fund are entitled to the basic prescription coverage as follows: Copays at retail: $10 generic/$30 formulary/$58 non-formulary brand/25% for biologicals for 30-day supply.  Mail order:  $20 generic/$58 formulary/$116 non-formulary brand name for 90-day supply.  $2,250 annual maximum.

Retirees in union welfare funds where prescription drugs are not covered will automatically receive the following prescription drug benefit:   Copays at retail: $10 generic/$25 formulary/$50 non-formulary brand name/25% for biologicals for 30 day supply.  Mail order: $20 generic/$50 formulary/$100 non-formulary brand name/25% for biologicals.  Unlimited annual maximum. 

Cost
See rate page for pension deductions.
See the rate page

For More Information
Call the plan at (800) 809-7328 if you have any questions or to reserve a place at an information meeting in your community. Please identify yourself as a City of New York Retiree.
Visit the Plan Web site (opens in a new window)

*  Benefits are subject to change per Centers for Medicaid and Medicare Services (CMS). 
** Co-payments may apply

Updated to reflect changes effective January 1, 2006