|Covered Benefits (Individual and Family)
|Your Annual Checkup (Preventive Care)
No deductible or cost sharing applies to recommended preventive care visits or services
|Primary Care Provider (PCP) Visit
|Inpatient Facility/Skilled Nursing Facility
|Physical, Occupational, and Speech Therapies
The benefit information provided above is a brief summary, not a comprehensive description, of benefits.
Summary of Benefits (English / Español / 中文)
For help understanding terms like deductible and copay, please visit the Glossary.
|Maximum Out-of-Pocket Cost
|Maximum Out-of-Pocket Cost
For help understanding terms like deductible and maximum out-of-pocket, please visit the Glossary.
|Prescription Drugs (Individual and Family) 30-day Supply
|Generic (Tier 1)
|Brand Name Preferred (Tier 2)
|Brand Name Non-Preferred (Tier 3)
2019 Pro Plan Comprehensive Formulary
24/7 Access to Telemedicine with Teladoc*
Talk to a doctor any time—for a $0 copay—with Teladoc! Connect with U.S. board-certified doctors through video chat or over the phone who can diagnose, treat, and prescribe medicine for non-emergency conditions.
Visit Teladoc.com today to learn more!
Convenient Access to Care with the Healthfirst Urgent Care Center Network
Get the care you need when you need it at an urgent care center in our network. Visit an in-network urgent care center to get care for non-emergency conditions like earaches, upset stomachs, and sprains; for wounds that require stitches; and more.
Urgent care centers offer late-night and weekend hours, with faster service and lower costs than the emergency room. Plus, you don’t need an appointment.
Visit HFDocFinder.org to search for an urgent care center near you!
Rewards for Working Out with ExerciseRewards™
Earn rewards for taking care of your health—up to $400 in a plan year** with the program!
It’s easy! Just work out at a qualifying fitness center at least 50 times in a six-month reward period and submit a record of your visits.
Your covered spouse or domestic partner can be rewarded too—up to $200 in a plan year† when he or she works out at least 50 times during a six-month reward period.
Visit the ExerciseRewards™ program to learn more!
Discounted Access to Local Fitness Centers with Active&Fit Direct™
Working out just got easier. For just $25/month plus a one-time enrollment fee of $25, you can get a standard membership to a fitness center in your area through the program. Track your activity, monitor your progress, and achieve your fitness goals!
Please note: a three-month membership commitment is required.
Visit Active&Fit Direct to learn more!
*Telemedicine isn’t a replacement for your Primary Care Provider (PCP). Your PCP should always be your first choice for care and for regular visits.
**Up to $200 per reward period.
†Up to $100 per reward period.
The ExerciseRewards and Active&Fit Direct programs are provided by American Specialty Health Fitness, Inc. (ASH Fitness), a subsidiary of American Specialty Health Incorporated (ASH). Members are not required to participate at an ASH-contracted fitness center to be eligible for the reward; however, exclusions apply. For a fitness center to qualify, it must offer regular cardiovascular, flexibility, and/or resistance training exercise programs or may include instructor-led classes (such as Zumba®, Pilates, “step” classes, yoga, aquatics, etc.), must have staff oversight, and must offer a membership agreement. The ExerciseRewards and Active&Fit Direct programs are health improvement and education programs and are not insurance.
ASH Fitness is a separate company that administers the ExerciseRewards and Active&Fit Direct programs on behalf of Healthfirst.
Prior to participating in this or any other exercise program, it is important for you to seek the advice of a physician or other qualified health professional. Incentives may be taxable income that you are responsible to report. Your health plan is committed to helping you achieve your best health. If you think you might be unable to meet a standard for a reward under this wellness program, you might qualify for an opportunity to earn the same reward by different means. Contact us at 1-877-810-2746, Monday to Friday, 8am–9pm Eastern Time, and we will explain how you can work with your physician to find an alternative wellness program with the same reward that is right for you in light of your health status.
© 2019 American Specialty Health Incorporated (ASH). All rights reserved. Active&Fit Direct, ExerciseRewards, the ExerciseRewards and Active&Fit Direct logos, and ExerciseRewards CheckIn! are trademarks of ASH.
To get a quote for your business, you can:
• Contact your broker
• Call us at 1-855-949-3668, Monday to Friday, 9am–5pm
• Fill out a form; one of our representatives will contact you
If you’re an individual looking for a health insurance plan, visit the Healthfirst Plan Finder now to find one that’s right for you.