The Healthfirst CompleteCare Plan is a Medicare Advantage Dual-Eligible Special Needs plan that offers members the benefits of Original Medicare and Medicaid, plus prescription drug coverage, dental, vision, and hearing coverage, over-the-counter (OTC)/healthy foods and produce allowance, the SilverSneakers® fitness program, acupuncture, and more. You’ll also get a Care Team that will help you develop your own personal care plan centered around your care goals and coordinate the services you need in order to meet your care goals and remain independent. And, you don’t need referrals to see in-network specialists. This plan is designed for people who have both Medicare and full Medicaid and need in-home care and long-term care services.
Plan Highlights:
- Prescription drug coverage
- Comprehensive dental
- Vision exams and eyeglasses
- Hearing exams and hearing aids
- Over-the-counter (OTC) allowance for nonprescription items, healthy foods and produce
- SilverSneakers® fitness program
- Acupuncture
- Long Term Care benefits (I.e. Care Management Team, personal care services)
- 2021
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 isn’t a replacement for your Primary Care Provider (PCP). Your PCP should always be your first choice for care and for routine 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 the SilverSneakers network of fitness facilities and to group exercise classes, classes held at parks and community locations, and at-home kits.
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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 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
Additional Plan Highlights
Frequently Asked
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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
Can't talk right now?
Request a callback and we’ll get back to you within one business day.
You can also visit our Virtual Community Office to connect with a local Healthfirst representative or to find a community office near you.
If you receive Medicaid and want to know whether you are eligible for a managed long-term care plan, you can call the Conflict-Free Evaluation and Enrollment Center (CFEEC) at 1-855-222-8350, Monday to Friday, 8:30am—8pm, and Saturday, 10am—6pm, to schedule a free evaluation.