65 Plus Plan (HMO)

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, and 24/7 access to care with Teladoc® 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 Program (MSP), or Medicaid.

Plan Highlights:

  • Dental
  • No-cost preferred generic drugs
  • Vision exams and eyeglasses
  • Hearing exams and hearing aids
  • Acupuncture
  • 2019
65 Plus Plan (HMO)
Summary of Benefits and Coverage (PDF)
English
Premium
$0
Eligible Age
65 or older (or under 65 with certain disabilities)
Eligible Location
Within New York City's five boroughs (the Bronx, Brooklyn, Manhattan, Queens, and Staten Island) and Nassau County
Other Eligibility Requirements
Qualify for Medicare Part A
Enroll and continue to pay for Medicare Part B
Do not have End-Stage Renal Disease (ESRD), except under certain circumstances
Preventive Dental
$0 copay; up to $1,500 maximum per year
Vision
$0 copay
Hearing
$45 copay
Acupuncture
$0 copay for up to 15 visits per year
Teladoc
$0 copay
Nurse Help Line Access
$0 copay
Meal Delivery
$0 copay for up to 42 meals delivered to your home for up to 14 days following an inpatient hospital stay greater than two days, if recommended by a provider
More Plan Information

Additional Plan Highlights

  • 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 isn’t a replacement for your Primary Care Provider (PCP). Your PCP should always be your first choice for care and for routine visits.

  • 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.

  • 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.

  • 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 usually 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).
    • Personal medication list that lists 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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  • Healthfirst Medication Therapy Management Program

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Frequently Asked
Questions

See All
  • Can I save money on my healthcare costs?
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  • How do I use my coverage at the pharmacy?
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  • Do generic drugs work as well as brand name drugs?
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Support When You Need It

We're happy to answer your questions.

Learn about enrollment

1-877-237-1303

7 days a week, 8am—8pm

TTY English: 1-888-542-3821

TTY Español: 1-888-867-4132

Member Services

1-888-260-1010

7 days a week, 8am—8pm

TTY English: 1-888-542-3821

TTY Español: 1-888-867-4132

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