This plan is for those who need help with day-to-day activities like bathing and meal preparation, and who live in their own home and community. This plan combines Medicare and Medicaid benefits, including long-term care, into one plan. It also covers a wide range of other benefits Original Medicare does not cover, like an OTC Plus card, eyewear allowance, and no-cost support for caregivers.
Quick links
Long-term care benefits, such as personal care services, access to adult day healthcare centers and more
Dedicated Care Team to help you meet your care goals and live independently at home
$256/month OTC Plus card for over-the-counter (OTC) items, exercise equipment, and activity trackers. If eligible, you can also use the card for healthy foods, home utilities, and more.1
Support for caregivers through Carallel®
Comprehensive dental, including dentures and replacements, crowns, root canals, and implants, subject to medical necessity
$0 copay for all other covered services, including entry-level hearing aids
We want to help you get the most out of your Part D prescription drug benefits. To confirm that your drugs are covered and to see which medications fall under each tier, use the Healthfirst prescription drug search tool or view the CompleteCare (HMO D-SNP) formulary. Healthfirst may add drugs to or remove them from its Medicare formulary during the year. You will receive notice when changes are made.
For safety and cost reasons, plans may limit the amount of a prescription drug they cover over a certain period of time. For example, most people who are prescribed heartburn medication take one tablet a day for four weeks. Therefore, a plan may cover only an initial 30-day supply of the heartburn medication. The quantity allowed is listed after the QL symbol in your formulary and may be read as “units per days’ supply.” If your prescription for any of these medications exceeds the maximum quantity listed, you and your doctor will need to request a formulary exception.
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 virtual dermatologists and mental health services is also available.
Talk to a nurse any time—for a $0 copay. Get wellness advice and help finding a doctor.
Get the care you need when you need it at an urgent care center in our network—no appointment needed. Urgent care centers offer convenient late-night and weekend hours. 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.
Get access to live classes and workshops taught by instructors trained in senior fitness, hundreds of workout videos in the SilverSneakers On-Demand™ online library, online fitness and nutrition tips, and their mobile app with digital workout programs.
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:
When you're eligible for both Medicare and Medicaid, you qualify for a Dual-Eligible Special Needs Plan (D-SNP) like CompleteCare. Such a plan is designed to simplify how you receive care. Our care coordination helps all parts of your healthcare work together, rather than separately.
Instead of managing your care alone, you have access to a dedicated Care Team that can help:
This is especially important for people managing chronic conditions such as diabetes, dementia, heart disease, or COPD, or who have mobility limitations that demand ongoing care and monitoring.
One of the biggest advantages of a D-SNP like CompleteCare is how it brings Medicare and Medicaid together under one plan. Without coordination, these programs can feel disconnected-covering different services with different rules.
CompleteCare helps coordinate your care by:
Your healthcare needs don't stay the same. Whether you're recovering from a hospital stay or managing a long-term condition, care coordination helps ensure your coverage changes with you.
CompleteCare supports you with:
The goal is simple: to help you receive the right care, at the right time, and in the right place.
CompleteCare provides a Care Team that will cover home care services such as short-term home healthcare like skilled nursing care and therapies and long-term services like a Personal Care Aide.
The Healthfirst CompleteCare (HMO D-SNP) plan covers preventive dental care such as semi-annual checkups, cleanings, and fluoride treatment. Plus, comprehensive dental care, including dentures and replacements, crowns, root canals, extractions, and implants.
Search for an in-network dentist at HFDocFinder.org.
Dental services must be medically necessary; limitations and exclusions apply.
Dual Eligible Special Needs Plans are designed specifically for people who qualify for both Medicare and Medicaid.
In general, you may qualify for a D-SNP like CompleteCare if:
This combination is often referred to as being "dual eligible."
To qualify for CompleteCare, you must also:
See Costs and Plan Details for more information.
There are no out-of-pocket costs for in-network covered services for CompleteCare members. Be sure to take advantage of your plan benefits, such as no-cost annual physical and dental checkups, to keep you healthy and identify potential health risks early.
Pharmacy benefits are different for each Healthfirst health insurance plan. Please check your plan's formulary for more information on which prescription medicines and other items are covered.
Healthfirst has partnered with CVS Caremark to bring you a personal prescription drug account that will give you 24/7 access to important drug benefit information and tools that will make getting your prescription drugs easier. Click here to create your account or log in.
1These are special supplemental benefits for members enrolled in a Healthfirst dual-eligible special needs plan. To be eligible, you must have a chronic condition such as cardiovascular disorder, disabling mental health condition, diabetes, lung disorders, obesity, or another eligible condition not listed. Benefit eligibility is not based on your chronic condition alone.
2Dental services must be medically necessary; limitations and exclusions apply.
This information is not a complete description of benefits. Contact the plan for more information. Benefits, premiums, and/or copayments/coinsurance may change on January 1 of each year.
The formulary, pharmacy network, and/or provider network may change at any time. You will receive notice when necessary.
Coverage is provided by Healthfirst Health Plan, Inc., which offers HMO plans with a Medicare contract. Our SNPs also have contracts with the NY State Medicaid program. Enrollment in Healthfirst Medicare Plan depends on contract renewal.
Plans contain exclusions and limitations.
ATENCIÓN: Dispone de servicios de asistencia lingüística y otras ayudas, gratis. Llame al 1-866-305-0408 (TTY: 1-888-867-4132).
请注意：您可以免费获得语言协助服务和其他辅助服务。请致电 1-866-305-0408 (TTY: 1‑888‑542‑3821)。
OTC items are subject to the plan’s list of eligible items and the plan’s participating network of retail, online, and utility providers.
No out-of-pocket costs for entry-level hearing aids. Eyewear allowance can only be used at participating retailers.
DentaQuest® is contracted with Healthfirst to provide dental benefits to its members.
EyeMed® is contracted with Healthfirst to provide vision benefits to its members.
Telemedicine (Teladoc Health) and the Nurse Help Line are not replacements for your primary care provider (PCP). Your PCP should always be your first choice for care (both in-person and virtual visits).
SilverSneakers is a registered trademark of Tivity Health, Inc. © 2026 Tivity Health, Inc. All rights reserved.
The benefits mentioned are a part of special supplemental program for the chronically ill. Not all members qualify.
Last update October 6, 2026 @ 2:11 pm
Y0147_MKT27_49 26-5421_M
Long-term care benefits, such as personal care aide services, adult day health center, social day center, and more
Dedicated Care Team to help you meet your care goals and live independently at home
$252/month OTC Plus card for over-the-counter (OTC) items, healthy foods, exercise equipment, activity trackers, home utilities (including gas, oil, electric, water, and internet service), and more1
Support for caregivers through Carallel®
Comprehensive dental, including dentures, crowns, root canals for $0
$0 copay for all other covered services, including free entry-level hearing aids
We want to help you get the most out of your Part D prescription drug benefits. Please refer to the formulary below to see which medications are covered. Healthfirst may add drugs to or remove them from its Medicare formulary during the year. You will receive notice when changes are made.
For safety and cost reasons, plans may limit the amount of a prescription drug they cover over a certain period of time. For example, most people who are prescribed heartburn medication take one tablet a day for four weeks. Therefore, a plan may cover only an initial 30-day supply of the heartburn medication. The quantity allowed is listed after the QL symbol in your formulary and may be read as “units per days’ supply.” If your prescription for any of these medications exceeds the maximum quantity listed, you and your doctor will need to request a formulary exception.
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 Health) 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).
Talk to a nurse any time—for a $0 copay. Get wellness advice and help finding a doctor.
Telemedicine (Teladoc Health) and the Nurse Help Line are not replacements for your primary care provider (PCP). Your PCP should always be your first choice for care (both in-person and virtual visits).
Get the care you need when you need it at an urgent care center in our network – no appointment needed. Urgent care centers offer convenient late-night and weekend hours. 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.
Get access to live classes and workshops taught by instructors trained in senior fitness, hundreds of workout videos in the SilverSneakers On-Demand™ online library, online fitness and nutrition tips, and their mobile app with digital workout programs.
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:
For individuals eligible for both Medicare and Medicaid, our Dual-Eligible Special Needs plans (D-SNPs) are designed to make Part D prescription drugs, healthy foods, and even home utilities more affordable!
Medicare Special Needs Plans (SNPs) are a type of Medicare Advantage Plan that limit membership to people with specific diseases or characteristics. Medicare SNPs tailor their plan benefits, provider choices, and drug formularies to best meet the specific needs of the members they serve.
Our CompleteCare (HMO D-SNP) Medicare Advantage Prescription Drug plan is designed to help our members live better, healthier lives with Long Term Services and Supports (LTSS), a monthly OTC Plus card allowance that can be used for healthy foods,1 and more. Plus, there are no out-of-pocket costs for CompleteCare members.
With the Healthfirst CompleteCare (HMO D-SNP) Medicare Advantage Prescription Drug plan, you receive an OTC Plus card that can be used to pay for over-the-counter (OTC) non-prescription medicines and health-related items, healthy foods, exercise equipment and activity trackers, or even home utilities such as gas, oil, electric, water, and internet service.*
The Healthfirst CompleteCare (HMO D-SNP) plan covers preventive dental care such as yearly checkups, cleanings, and fluoride treatment. Plus, comprehensive dental care including dentures, crowns, root canals, and extractions.
Dental services must be medically necessary; limitations and exclusions apply.
There are no out-of-pocket costs for in-network covered services for CompleteCare members. Be sure to take advantage of your plan benefits, such as annual physical and dental checkups, to keep you healthy and identify potential health risks early.
Pharmacy benefits are different for each Healthfirst health insurance plan. Please check your plan’s formulary for more information on which prescription medicines and other items are covered.
Healthfirst has partnered with CVS Caremark to bring you a personal prescription drug account that will give you 24/7 access to important drug benefit information and tools that will make getting your prescription drugs easier. Click here to create your account or log in.
1Healthy foods and home utilities are special supplemental benefits for members enrolled in a Healthfirst dual-eligible special needs plan. To be eligible, you must have a chronic condition such as cardiovascular disorder, disabling mental health condition, diabetes, lung disorders, obesity, or another eligible condition not listed. Benefit eligibility is not based on your chronic condition alone.
2Dental services must be medically necessary; limitations and exclusions apply.
This information is not a complete description of benefits. Contact the plan for more information. Benefits, premiums, and/or copayments/coinsurance may change on January 1 of each year.
The formulary, pharmacy network, and/or provider network may change at any time. You will receive notice when necessary.
Coverage is provided by Healthfirst Health Plan, Inc., which offers HMO plans with a Medicare contract and a contract with the NY State Medicaid program. Enrollment in Healthfirst Medicare Plan depends on contract renewal.
Plans contain exclusions and limitations.
ATENCIÓN: Dispone de servicios de asistencia lingüística y otras ayudas, gratis. Llame al 1-866-305-0408 (TTY: 1-888-867-4132).
请注意：您可以免费获得语言协助服务和其他辅助服务。请致电 1-866-305-0408 (TTY: 1‑888‑542‑3821)。
OTC items are subject to the plan’s list of eligible items and the plan’s participating network of retail, online, and utility providers.
No out-of-pocket costs for entry-level hearing aids. Eyewear allowance can only be used at participating retailers.
DentaQuest® is contracted with Healthfirst to provide dental benefits to its members.
EyeMed® is contracted with Healthfirst to provide vision benefits to its members.
Telemedicine (Teladoc Health) and the Nurse Help Line are not replacements for your primary care provider (PCP). Your PCP should always be your first choice for care (both in-person and virtual visits).
SilverSneakers is a registered trademark of Tivity Health, Inc. © 2026 Tivity Health, Inc. All rights reserved.
The benefits mentioned are a part of special supplemental program for the chronically ill. Not all members qualify.
Y0147_MKT26_54 5319-25_M
Last update October 6, 2026 @ 2:11 pm
Monday to Friday, 8am–8pm
We can help you enroll by phone, video chat, or in person.
If you receive Medicaid and want to know whether you are eligible for a Managed Long-Term Care Plan, you can call the New York Independent Assessor (NYIA) formerly Conflict-Free Evaluation Enrollment Center (CFEEC) at 1-855-222-8350, TTY at 1-888-329-1541, Monday to Friday, 8:30am–8pm, and Saturday, 10am–6pm, to schedule your initial assessment.