GuildNet Gold - Medicare Advantage Prescription Drug Plan and GuildNet Gold Medicaid Advantage Plus is designed for people who have both Medicare and Medicaid (Dual Eligible) and are eligible for nursing home level of care. Some of the services we cover are:

• Physician care (primary and specialty care covered with no referral requirement)
• Inpatient hospital care
• Home health care, including personal care
• Emergency and Urgent Care
• Rehabilitation
• DME / Supplies
• Adult Day Health Care
• Personal Emergency Response System
• Hearing Services
• Vision Services
• Case Management
• Health/Wellness Education
• Dental
• Transportation (Routine and Emergent)
• Medicare Part D Prescription Drugs

Not all covered services are listed. Please see the Summary of Benefits and Evidence of Coverage for more information.

Plan Premium and Extra Help

Because GuildNet Gold members have Medicaid, they automatically receive extra help paying for
their premiums, deductibles and co-pays. As a member of GuildNet Gold, you pay:

• $0 Plan Premium for medical and prescription drug benefits
• $0 Deductible
• $0 co-pays for covered medical benefits
• $0 to $6.50 for Part D prescription drugs, depending on the drug tier and your level of extra help.
• no Part D coverage gap

Members who pay a Medicare Part B premium must continue to pay it. For more information about Extra Help, contact Social Security Administration at 1-800-772-1213 between 7 a.m. and 7 p.m., Monday through Friday. TTY/TDD users should call 1-800-325-0778; call 1-800-MEDICARE (1-800-633-4227), 24 hours per day, 7 days per week. TTY users should call 1-877-486-2048 or your local Medicaid office.

Benefits may change each year on January 1st. Please contact GuildNet for details.
GuildNet’s contract with Medicare is renewed annually and coverage beyond the end of
the contract year is not guaranteed.

Eligibility Requirements for Enrollment

• Age 18 or older
• Reside in Brooklyn, Queens, Manhattan, the Bronx, Nassau or Suffolk
• Have Medicaid AND Medicare Part A & B.
• Eligible for nursing home level of care (as of the time of
enrollment)
• Capable, at the time of enrollment, of returning to or remaining in your
  home and community without jeopardy to your health and safety
• Expected to need care management and long-term care services for at
  least 120 days from the date of your enrollment.

E-mail us, and a sales agent will call you to discuss
the Medicare Special Needs Plan. The person that
will be discussing plan options with you is employed
by a Medicare health plan that is not the Federal government,
and they may be compensated based on your enrollment in plan.

E-mailing us does NOT affect your current enrollment, nor will it
enroll you in a Medicare Advantage Plan, Prescription Drug Plan,
or other Medicare plan.

If you have a complaint related to our plan, providers, or pharmacies, please call our Member Services Department at 1-800-815-0000, Monday – Friday 8:00am to 8:00pm and we will do our best to assist you over the phone. TTY users should call 1-800-662-1220. You can also write to us at the address above or file a complaint electronically by clicking here File a Complaint (by clicking here you will be leaving the GuildNet website)