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Forms & Documents
Viewing documents for:
Medicare & Managed Long Term Care Plans
* = managed long-term care plan
Plan Documents
Member Resources
65 Plus Plan (HMO)
CompleteCare (HMO SNP)*
Coordinated Benefits Plan (HMO)
Increased Benefits Plan (HMO)
Life Improvement Plan (HMO SNP)
Signature (HMO)
Medicare Part D Resources
Medicare Advantage Plan Enrollment Resources
Privacy, Protected Health Information (PHI), and Non-Discrimination
General Forms, Documents, and Resources
Member Resources
2021 Star Ratings
Every year, Medicare evaluates plans based on a 5-star rating system.
65 Plus Plan (HMO)
CompleteCare (HMO SNP)*
Coordinated Benefits Plan (HMO)
Increased Benefits Plan (HMO)
Life Improvement Plan (HMO SNP)
Senior Health Partners*
Signature (HMO)
Medicare Part D Resources
Medicare Advantage Plan Enrollment Resources
Privacy, Protected Health Information (PHI), and Non-Discrimination
Medicare Advantage Members:
Premiums, copays, coinsurance, and deductibles may vary based on the level of Extra Help you receive. Please contact the plan for further details.
Coverage is provided by Healthfirst Health Plan, Inc., Healthfirst PHSP, Inc., and/or Healthfirst Insurance Company, Inc. (together, “Healthfirst”). Plans contain exclusions and limitations.
Healthfirst Health Plan, Inc. offers HMO plans that contract with the Federal Government. Healthfirst Medicare Plan has a contract with New York State Medicaid for Healthfirst CompleteCare (HMO SNP) and a Coordination of Benefits Agreement with the New York State Department of Health for the Healthfirst Life Improvement Plan (HMO SNP). Enrollment in Healthfirst Medicare Plan depends on contract renewal.
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).
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 April 8, 2021 @ 3:33 pm
Y0147_MKT21_46 1226-20_2021
Medicaid Plans
Plan Documents
Essential Plan 1
Medicaid Managed Care
Personal Wellness Plan
Child Health Plus
Member Resources
Privacy and Protected Health Information (PHI)
Essential Plan 2
Essential Plan 3
Essential Plan 4
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Gold
Silver
Bronze
Green
General Forms, Documents, and Resources
Essential Plan 1
Medicaid Managed Care
Personal Wellness Plan
Child Health Plus
Member Resources
Privacy and Protected Health Information (PHI)
Essential Plan 2
Essential Plan 3
Essential Plan 4
Platinum
Gold
Silver
Bronze
Green
Essential Plans
Plan Documents
Essential Plan 1
Medicaid Managed Care
Personal Wellness Plan
Child Health Plus
Member Resources
Privacy and Protected Health Information (PHI)
Essential Plan 2
Essential Plan 3
Essential Plan 4
Platinum
Gold
Silver
Bronze
Green
General Forms, Documents, and Resources
Essential Plan 1
Medicaid Managed Care
Personal Wellness Plan
Child Health Plus
Member Resources
Privacy and Protected Health Information (PHI)
Essential Plan 2
Essential Plan 3
Essential Plan 4
Platinum
Gold
Silver
Bronze