65 Plus Plan (HMO)

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The Healthfirst 65 Plus Plan is a Medicare Advantage plan that offers the benefits of Original Medicare, plus prescription drug coverage, dental, hearing, vision, acupuncture, the SilverSneakers® fitness program, 24/7 access to care via phone or video chat, and the Nurse Help Line. And you don’t need referrals to see in-network specialists. This plan is designed for people who do not qualify for programs like Extra Help (also known as Low Income Subsidy), Medicare Savings Programs (MSP), or Medicaid.

Plan Highlights:

  • No-cost preferred generic drugs
  • Low-cost doctor visits
  • Comprehensive dental
  • Hearing exams and hearing aids
  • Vision exams and eyeglasses
  • Acupuncture
  • 2023

This information is not a complete description of benefits. Contact the plan for more information. Benefits, premiums, and/or copayments/coinsurance may change each year. The formulary, pharmacy network, and/or provider network may change at any time. You will receive notice when necessary.

You must continue to pay your Medicare Part B premium.

Coverage is provided by Healthfirst Health Plan, Inc. or Healthfirst Insurance Company, Inc. Plans contain exclusions and limitations.

No out-of-pocket costs for entry-level hearing aids. Eyewear allowance can be used at participating retailers.

Some dental services must be medically necessary to be covered; limitations and exclusions apply.

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).

Last update August 17, 2023 @ 10:11 am

Y0147_MKT23_90 0816-22_2023

Additional Plan Highlights

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    24/7 Access to Telemedicine with Teladoc*

    Talk to a doctor any time—for a $0 copay. Visit with board-certified doctors through video chat or phone for prescriptions, treatment of non-emergency health issues, and more. Access to dermatologists is also available.

    *Telemedicine (Teladoc) isn’t a replacement for your primary care provider (PCP). Your PCP should always be your first choice for care (both in-person and virtual visits).

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    24/7 Access to care with the Nurse Help Line

    Talk to a nurse any time—for a $0 copay. Get wellness advice and help finding a doctor.

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    Urgent Care Center Network

    Get the care you need when you need it at an urgent care center in our network – no appointment needed. Urgent care centers offer late-night and weekend hours, often with faster service at a lower cost than the emergency room (ER). Visit an in-network urgent care center to get help with non-emergency health issues like earache, upset stomach, and sprains; for wounds that need stitches; and more.

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    SilverSneakers

    Get access to live classes and workshops taught by instructors trained in senior fitness, 200+ workout videos in the SilverSneakers On-Demand online library, online fitness and nutrition tips, and their mobile app with digital workout programs.

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    Healthfirst Medication Therapy Management Program

    The Healthfirst Medication Therapy Management (MTM) program is an in-depth, one-on-one review of all your medications (prescription drugs, over-the-counter nonprescription drugs, and herbal and nutritional supplements). The goal is to help you get the most from your medications. Services include:

    • Phone consultation with a licensed pharmacist to complete a Comprehensive Medication Review (CMR). The call will take about 30 to 60 minutes and the pharmacist will answer any questions you may have. (A CMR is offered once each year, if you qualify.)
    • Medication Action Plan (MAP)
    • Medication recommendations may be sent to your provider from the MTM pharmacist, also known as Targeted Medication Review (TMR)
    • A list that shows all your medications

    Learn More

Additional Plan Highlights

  • 24/7 Access to Telemedicine with Teladoc*

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  • 24/7 Access to care with the Nurse Help Line

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  • Urgent Care Center Network

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  • SilverSneakers

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  • Healthfirst Medication Therapy Management Program

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Frequently Asked
Questions

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  • Can I save money on my healthcare costs? FAQ dropdown arrow
  • How do I use my coverage at the pharmacy? FAQ dropdown arrow
  • Do generic drugs work as well as brand name drugs? FAQ dropdown arrow

Support When You Need It

We’re happy to answer your questions. Our service centers hours are:

  • October through March, 7 days a week, 8am—8pm
  • April through September, Monday to Friday, 8am–8pm

Learn about enrollment

1-877-237-1303

TTY English: 1-888-542-3821

TTY Español: 1-888-867-4132

Member Services

1-888-260-1010

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.

The following link will take you to Medicare.gov where you can enroll online.

CMS Online Enrollment Center