Connection Plan (HMO D-SNP)

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The Healthfirst Connection Plan is a Medicare Advantage Dual-Eligible Special Needs (HMO D-SNP) plan that works directly with your existing Healthfirst Medicaid plan and offers members the benefits of Original Medicare and Medicaid, and more, such as prescription drugs, OTC Plus card, SilverSneakers® fitness program, 24/7 access to care via phone or video chat and more. Plus, you don’t need referrals to see in network specialists. This plan is designed only for current members of a Healthfirst Medicaid plan.

*Please call Member Services at 1-888-260-1010 for more information on this plan

Plan Highlights:

  • Prescription drug coverage
  • OTC Plus card for OTC and health-related items, healthy foods, and home utilities (gas, water, electric, oil, and internet service)
  • Comprehensive dental (through your Healthfirst Medicaid plan)
  • Hearing exams and hearing aids (through your Healthfirst Medicaid plan)
  • Vision exams and eyeglasses (through your Healthfirst Medicaid plan)
  • SilverSneakers fitness program
  • 2024
Connection Plan (HMO D-SNP)
Summary of Benefits (PDF)
Eligible Age
65 or older (or under 65 with certain disabilities)
Eligible Service Areas
Reside within New York City’s five boroughs (The Bronx, Brooklyn, Manhattan, Queens, and Staten Island), Nassau, Suffolk, Orange, Rockland, Sullivan, and Westchester counties.
Other Eligibility Requirements
Qualify for Medicare Part A (you are 65 or older, or under 65 with certain disabilities) and Part D.
Enroll in and continue to pay for Medicare Part B. Medicaid covers Medicare Part B premiums for dual-eligible members with full Medicaid coverage.
Are newly eligible for Medicare and currently enrolled in Healthfirst's Medicaid Managed Care or Personal Wellness Plans.
Enrollment Period
Only members with Healthfirst Medicaid Managed Care or Personal Wellness Plan will be enrolled when they reach Medicare eligibility.
OTC Plus Card
$285 per quarter OTC Plus card for OTC non-prescription drugs and health-related items, healthy foods, fitness equipment, activity trackers, and home utilities (including internet services)
$0 copay; covered under Healthfirst Medicaid
$0 copay; covered under Healthfirst Medicaid
$0 copay; covered under Healthfirst Medicaid
$0 copay for up to 20 acupuncture visits for chronic lower back pain
Nurse Help Line Access
$0 copay
Telemedicine (Teladoc)
$0 copay
Meal Delivery
$0 copay for up to 84 meals delivered to your home for up to 28 days following a discharge from hospital to home or from a skilled nursing facility to home with a stay greater than two days, if recommended by a provider.
Costs & Benefits
Connection Plan (HMO D-SNP)
Medical Deductible
Maximum Out-of-Pocket
Your Annual Checkup
$0 copay
Primary Care Provider (PCP) Visit
$0 copay
Specialist Visit
$0 copay
Outpatient Lab Tests (including COVID-19)
$0 copay
Retail Health Clinic
$0 copay
Urgent Care
$0 copay
Emergency Room
$0 copay
$0 copay
Ambulatory Surgery Visit
$0 copay
Outpatient Facility
$0 copay
Inpatient Hospital Stay
$0 copay
Skilled Nursing Facility
$0 copay

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 fall under each tier. Healthfirst may add drugs to or remove them from its Medicare formulary during the year. You will receive notice when changes are made.

Depending on your level of Extra Help, you have to pay only the following for your prescription drugs (up to a 90-day supply):

Preferred Generic Drugs (Tier 1)
$0 copay
Generic Drugs (Tiers 2-5)
(including brand drugs treated as generic)
$0 copay or
$1.55 copay or
$4.50 copay
All Other Drugs
$0 copay or
$4.60 copay or
$11.20 copay

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.

You must continue to pay your Medicare Part B premium.

Coverage is provided by Healthfirst Health Plan, Inc. and Healthfirst PHSP, 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.

Healthfirst Medicare Plan, Inc. 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).

Dental services must be medically necessary; limitations and exclusions apply. No out-of-pocket costs for entry-level hearing aids. Eyewear allowance can only be used at participating retailers.

OTC items are subject to the plan’s list of eligible items and the plan’s participating network of retail, online, and utility providers.

Telemedicine (Teladoc) 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.© 2023 Tivity Health, Inc. All rights reserved.

DentaQuest® is contracted with Healthfirst to provide dental benefits to its members.

EyeMed® is contracted with Healthfirst to provide vision benefits to its members.

Last update January 18, 2024 @ 2:57 pm

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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 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.

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    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

See All
  • 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


TTY English: 1-888-542-3821

TTY Español: 1-888-867-4132

Member Services


TTY English: 1-888-542-3821

TTY Español: 1-888-867-4132

Need help enrolling in a health plan?

Request a call and our sales team will call 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 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.