{"id":115,"date":"2015-11-05T18:17:11","date_gmt":"2015-11-05T18:17:11","guid":{"rendered":"http:\/\/english2016-m.elderplan.org\/?page_id=115"},"modified":"2024-02-26T14:56:23","modified_gmt":"2024-02-26T19:56:23","slug":"member-update-form","status":"publish","type":"page","link":"https:\/\/elderplan0.wpengine.com\/zh\/member-benefits\/elderplan-benefits\/member-update-form\/","title":{"rendered":"Member Update Form"},"content":{"rendered":"\n<div class=\"wp-block-columns padding-interior is-layout-flex wp-container-core-columns-is-layout-9d6595d7 wp-block-columns-is-layout-flex\">\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\" style=\"flex-basis:66.66%\">\n<p>Do you need to make changes to your personal information?<\/p>\n\n\n\n<p><strong>Elderplan can help while ensuring your privacy.<\/strong><\/p>\n\n\n\n<p>Make changes or written requests in four easy steps:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Download this document to update the following information:<br><strong>Member Information Update Form<\/strong><a title=\"Member Information Update Form English\" href=\"\/wp-content\/uploads\/2018\/06\/2016-Information-Update-Form1_508.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">English<\/a> | <a title=\"Member Information Update Form Espa\u00f1ol\" href=\"\/wp-content\/uploads\/2018\/06\/2017-Information-Update-Form_v2_SPA_508-1.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">Espa\u00f1ol<\/a><br>(requires <a href=\"http:\/\/www.adobe.com\/products\/reader\/\">Adobe Reader<\/a>, free from Adobe Systems):\n<ul class=\"wp-block-list\">\n<li>Change of address<\/li>\n\n\n\n<li>Change Primary Care Physician (PCP)<\/li>\n<\/ul>\n<\/li>\n\n\n\n<li>Get a new Elderplan member card (Reminder: While you DO NOT use your Medicare card for medical services, be sure to keep it in a safe place)<\/li>\n\n\n\n<li>Print the form on your computer\u2019s printer<\/li>\n\n\n\n<li>Fill in the form completely, including your Elderplan Member ID number<\/li>\n\n\n\n<li>Mail or fax your form to the following address:<strong><br>Elderplan Member Service<\/strong><br>55 Water Street 46th Floor, Suite 202<br>New York, NY 10041<br>Fax: <a href=\"tel:+17186302624\">718-630-2624<\/a><\/li>\n<\/ul>\n\n\n\n<p>If you have any questions about changes you make to your personal information or any written requests, please don\u2019t hesitate to contact Elderplan\u2019s <a href=\"\/elderplan\/contact-elderplan\/\">Member Services Department<\/a>.<\/p>\n\n\n\n<p><strong>Elderplan Member Service<\/strong><br>55 Water Street 46th Floor, Suite 202<br>New York, NY 10041<br>Fax: <a href=\"tel:+17186302624\">718-630-2624<\/a><\/p>\n\n\n\n<p>If you have any questions about changes you make to your personal information or any written requests, please don\u2019t hesitate to contact Elderplan\u2019s <a title=\"Member Services Department\" href=\"\/for-members\/member-services\/\">Member Services Department<\/a>.<\/p>\n<\/div>\n\n\n\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\" style=\"flex-basis:33.33%\">\n<h2 class=\"wp-block-heading has-text-align-center\" id=\"h-looking-for-information\">Looking for information?<\/h2>\n\n\n\n<div class=\"wp-block-buttons is-vertical is-content-justification-center is-layout-flex wp-container-core-buttons-is-layout-9a7cdcfd wp-block-buttons-is-layout-flex\">\n<div class=\"wp-block-button has-custom-width wp-block-button__width-75 is-style-outline is-style-outline--2\"><a class=\"wp-block-button__link wp-element-button\" href=\"https:\/\/elderplan0.wpengine.com\/member-benefits\/elderplan-benefits\/provider-network\/\">Find a Provider<\/a><\/div>\n\n\n\n<div class=\"wp-block-button has-custom-width wp-block-button__width-75 is-style-outline is-style-outline--3\"><a class=\"wp-block-button__link wp-element-button\" href=\"\/member-benefits\/elderplan-benefits\/pharmacies\">Find a Pharmacy<\/a><\/div>\n\n\n\n<div class=\"wp-block-button has-custom-width wp-block-button__width-75 is-style-outline is-style-outline--4\"><a class=\"wp-block-button__link wp-element-button\" href=\"\/member-benefits\/elderplan-benefits\/prescription-drugs\/\">Find a Drug<\/a><\/div>\n\n\n\n<div class=\"wp-block-button has-custom-width wp-block-button__width-75 is-style-outline is-style-outline--5\"><a class=\"wp-block-button__link wp-element-button\" href=\"\/medicare-advantage-plan-options\/plan-materials\/find-a-form\/\">Find a Form<\/a><\/div>\n\n\n\n<div class=\"wp-block-button has-custom-width wp-block-button__width-75 is-style-outline is-style-outline--6\"><a class=\"wp-block-button__link wp-element-button\" href=\"\/files\/elderplan-broad-vaccine-network-vaccine-pharmacy-directory_updated_06012022_eng_accessible\/\">Find a Flu Shot<\/a><\/div>\n<\/div>\n\n\n\n<p class=\"has-text-align-center\">Questions? Call Elderplan today.<\/p>\n\n\n\n<h4 class=\"wp-block-heading has-text-align-center\" id=\"h-1-800-353-3765\"><a href=\"tel:1-866-353-3765\">1-800-353-3765<\/a><\/h4>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity hr vc_separator\">\n\n\n\n<h4 class=\"wp-block-heading has-text-align-center\" id=\"h-tty-711\"><a href=\"tel:1-866-353-3765\"><\/a><a href=\"tel:711\">[TTY: 711]<\/a><\/h4>\n\n\n\n<p class=\"has-text-align-center\"><strong>Hours of Operation:<\/strong><br>8 a.m. to 8 p.m., 7 days a week<\/p>\n\n\n\n<h5 class=\"wp-block-heading has-text-align-center\" id=\"h-elderplan-is-available-in-the-bronx-dutchess-kings-monroe-nassau-new-york-orange-putnam-queens-richmond-rockland-suffolk-westchester-ontario-orleans-seneca-yates-and-livingston-counties\">Elderplan is available in the Bronx, Dutchess, Kings, Monroe, Nassau, New York, Orange, Putnam, Queens, Richmond, Rockland, Suffolk, Westchester, Ontario, Orleans, Seneca, Yates, and Livingston counties.<\/h5>\n<\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>Do you need to make changes to [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":44,"menu_order":14,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_acf_changed":false,"footnotes":""},"categories":[],"class_list":["post-115","page","type-page","status-publish","hentry"],"translation":{"provider":"WPGlobus","version":"3.0.0","language":"zh","enabled_languages":["en","es","zh"],"languages":{"en":{"title":true,"content":true,"excerpt":false},"es":{"title":true,"content":true,"excerpt":false},"zh":{"title":false,"content":false,"excerpt":false}}},"acf":[],"jetpack_sharing_enabled":true,"publishpress_future_action":{"enabled":false,"date":"2026-05-05 22:54:18","action":"change-status","newStatus":"draft","terms":[],"taxonomy":"category","extraData":[]},"publishpress_future_workflow_manual_trigger":{"enabledWorkflows":[]},"_links":{"self":[{"href":"https:\/\/elderplan0.wpengine.com\/zh\/wp-json\/wp\/v2\/pages\/115","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/elderplan0.wpengine.com\/zh\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/elderplan0.wpengine.com\/zh\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/elderplan0.wpengine.com\/zh\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/elderplan0.wpengine.com\/zh\/wp-json\/wp\/v2\/comments?post=115"}],"version-history":[{"count":0,"href":"https:\/\/elderplan0.wpengine.com\/zh\/wp-json\/wp\/v2\/pages\/115\/revisions"}],"up":[{"embeddable":true,"href":"https:\/\/elderplan0.wpengine.com\/zh\/wp-json\/wp\/v2\/pages\/44"}],"wp:attachment":[{"href":"https:\/\/elderplan0.wpengine.com\/zh\/wp-json\/wp\/v2\/media?parent=115"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/elderplan0.wpengine.com\/zh\/wp-json\/wp\/v2\/categories?post=115"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}