Increased Benefits Plan (HMO)

Plan menu dropdown arrow

The Healthfirst Increased Benefits Plan (HMO) is a Medicare Advantage Prescription Drug plan ideal for people who qualify for Extra Help (also known as Low Income Subsidy [LIS], which helps lower prescription drug costs) and/or a Medicare Savings Program (MSP), which helps pay for some Medicare premiums, copays, or coinsurance. This plan offers the benefits of Original Medicare plus prescription drugs, dental, hearing, vision, an OTC Plus card, transportation, the SilverSneakers® fitness program, and more. And you don’t need referrals to see in-network specialists.

Plan Highlights:

  • Low or no copays for prescription drugs
  • Supplemental drug coverage for select prescription-strength vitamins
  • Comprehensive dental
  • Vision exams and eyeglasses
  • Hearing exams and hearing aids
  • An OTC Plus card for OTC nonprescription drugs and health-related items, healthy foods, fitness equipment and activity trackers, personal emergency response systems (PERS), and home utilities such as gas, oil, electric, water, and internet service
  • Rides to your healthcare providers
  • Acupuncture
  • 2024
  • 2023

This information is not a complete description of benefits. Contact the plan for more information. Benefits, premiums, and/or copayments/coinsurance may change 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., which offers HMO plans that contract with the Federal Government. Enrollment in Healthfirst Medicare Plan depends on contract renewal.

No out-of-pocket costs for entry-level hearing aids. Eyewear allowance can be used at participating retailers.

Dental services must be medically necessary to be covered; limitations and exclusions apply.

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

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

SilverSneakers is a registered trademark of Tivity Health, Inc.© 2020 Tivity Health, Inc. All rights reserved.

Healthfirst 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 November 27, 2023 @ 12:48 pm

Y0147_MKT24_67 1102-23_M

Additional Plan Highlights

  • Additional benefit image

    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).

  • Additional benefit image

    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.

  • Additional benefit image

    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.

  • Additional benefit image


    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.

  • Additional benefit image

    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*

    Additional benefits dropdown arrow
  • 24/7 Access to care with the Nurse Help Line

    Additional benefits dropdown arrow
  • Urgent Care Center Network

    Additional benefits dropdown arrow
  • SilverSneakers

    Additional benefits dropdown arrow
  • Healthfirst Medication Therapy Management Program

    Additional benefits dropdown arrow

Frequently Asked

See All
  • How do I qualify for the Healthfirst Increased Benefits Plan Medicare Advantage Prescription Drug plan? FAQ dropdown arrow
  • What can I purchase with the Healthfirst Increased Benefits Plan OTC Plus card? FAQ dropdown arrow
  • Where to buy OTC items with the OTC Plus card: FAQ dropdown arrow
  • What dental benefits are available with the Healthfirst Increased Benefits Plan? FAQ dropdown arrow
  • How can I save money on my healthcare costs? FAQ dropdown arrow
  • How do I use access my pharmacy benefits? 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

Can’t talk right now?

Request a callback and we’ll get back to you within one business day.

You can also visit us in person at one of our community offices.

The following link will take you to where you can enroll online.

CMS Online Enrollment Center