Medicare Eligibility | Healthfirst

Medicare Eligibility

Medicare provides coverage to people age 65 or older, or people under 65 with certain disabilities or permanent kidney failure. You should sign up for Medicare three months before reaching age 65, even if you’re not ready to start receiving Medicare benefits. Contact us today to help you get started with the Medicare enrollment process and discuss your coverage needs.

Enrolling for the First Time

Turning 65

You’ll have a seven-month period to enroll in Medicare. This period starts three months before your birth month and continues for three months after. If you miss your Initial Enrollment Period, you must wait until the General Enrollment Period (January 1–March 31) to enroll.

Social Security Recipients

If you’re under 65 and have a disability, you’re automatically enrolled in Part A and Part B after you get Social Security or Railroad Retirement benefits for 24 months.

+ 3 months

The Month of your 65th Birthday

+ 3 months

+ 3 months

Initial Enrollment Period

+ 3 months

Contact Social Security to Enroll in Medicare Parts A and B

Changing Plans

Annual and Open Enrollment Periods

If you’re unhappy with your current plan, have moved, or had a change in income, give us a call today and we’ll make it easy for you to switch your Medicare coverage.

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Medicare Annual Enrollment Period

October 15–December 7

During this period, you can

  • switch from Original Medicare to Medicare Advantage, or back to what you had.
  • switch from one Medicare Advantage plan to another, or from one Medicare Part D (prescription drug) plan to another.

Note: if you didn’t enroll in a Medicare Part D plan when you were first eligible, you can do so during this period.

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Medicare Advantage Open Enrollment Period

January 1–March 31

During this period, you have the one-time opportunity to

  • switch from one Medicare Advantage plan to a different one.
  • switch from your Medicare Advantage plan and return to Original Medicare.

Special Enrollment Periods

Have you recently moved or lost your coverage? There are certain life events that will allow you to switch coverage during other time periods.

Examples of live events include

  • moving outside your plan’s service area.
  • becoming eligible for both Medicare and Medicaid.
  • losing your health insurance.
Disenrollment

You can disenroll or change coverage during applicable enrollment periods.

Not sure if you should stay with your current coverage?
Give us a call and we’ll help you figure out the best Medicare option to fit your needs.

Switching between Medicare Advantage Plans

If you enroll in a new Medicare Advantage plan, you’ll be automatically disenrolled from your current one.

If you receive financial assistance from the government

You don’t need to wait for enrollment periods to disenroll from your plan.* You may disenroll by sending a signed and dated disenrollment request to Healthfirst Medicare plan in writing or by enrolling in another Medicare Advantage plan or Prescription Drug plan.

 

In the event that you did not mean to disenroll from Healthfirst Medicare Plan, you have the right and responsibility to ask us to cancel your disenrollment. However, you must notify us before the last day of the month you are enrolled in our plan. The effective date is the end of the month in which you made the completed request.
*You have the chance to disenroll once every three months during the first nine months of the year.

Switching back to Original Medicare.

You may disenroll from our plan and return to Original Medicare by asking us to disenroll you. We will send you written confirmation of your disenrollment that will be effective January 1 of the following year or at the end of the month in which you completed a request.

Mail or fax a coverage change notice to:

  • Healthfirst Member Services
  • P.O. Box 5165
  • New York, NY 10274-5165
  • Fax: 1-646-313-4618
Loss of Coverage

You’ll be automatically disenrolled from your Healthfirst Medicare Advantage Plan if

  • you enroll in another plan.
  • you lose entitlement to either Medicare Part A or B, lose special needs status, and do not regain your entitlement.
  • you’re not in the United States legally.
  • your Healthfirst Medicare Plan terminates its contract.
  • you permanently move outside of our service area, are absent from the service area for more than six consecutive months, or become incarcerated. To avoid gaps in coverage if you move, review information on Special Enrollment Periods.

In any of these circumstances, Healthfirst Medicare Plan will send you a letter to notify you of the reason for your disenrollment.

Learn how a Healthfirst Medicare Advantage Plan can benefit you

A Healthfirst representative will help you find out

  • if you’re eligible for Medicare.
  • when you can enroll in Medicare.
  • if you qualify for any financial assistance.
  • which plans benefits work for your personal needs.
  • if your current doctor and specialists are in the Healthfirst network.

Support When You Need It

We’re happy to answer your questions.

1-877-741-6511

7 days a week, 8am-8pm

TTY English: 1-888-542-3821
TTY Español: 1-888-867-4132

Can’t talk right now?

Request a callback and we’ll get back to you within one business day.
You can also visit us in person at one of our community offices.

Coverage is provided by Healthfirst Health Plan, Inc., Healthfirst PHSP, Inc., and/or Healthfirst Insurance Company, Inc. (together, “Healthfirst”). Plans contain exclusions and limitations.

Healthfirst Health Plan, Inc. offers HMO plans that contract with the Federal Government. Enrollment in Healthfirst Medicare Plan depends on contract renewal.

Healthfirst complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex.

ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 1-866-305-0408 (TTY 1-888-867-4132).

注意:如果您使用繁體中文,您可以免費獲得語言援助服 務。請致電1-866-305-0408 (TTY 1-888-542-3821).

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