Individual & Family Plans Marketplace Leaf & Leaf Premier Plans

Healthfirst Leaf and Leaf Premier Plans are Qualified Health Plans (QHPs) available through the NY State of Health Marketplace. Both plans offer comprehensive health coverage for individuals and families in New York, with options to fit different healthcare needs and budgets.

Explore our plans

Plan Year
CHOOSE PLAN LEVEL

Platinum Leaf Plan highlights

No-cost annual checkups

Preventive and wellness visits

Hospital, emergency room, and urgent care visits

Lab tests and X-rays

Prescription drug coverage

Maternity and newborn coverage

Optional adult dental and vision coverage

24/7 access to care with telemedicine (Teladoc Health)

Physical, occupational, and speech therapy

Annual gym membership reimbursement*

Costs and plan details

Platinum Leaf
Platinum Leaf Premier
Premium
Monthly premium costs depend on household income and size
Monthly premium costs depend on household income and size
Deductible (Individual)
Platinum Leaf $0
Platinum Leaf Premier $0
Deductible (Family)
Platinum Leaf $0
Platinum Leaf Premier $0
Eligible Age
Under 65
Under 65
Eligible Service Areas
Within New York City’s five boroughs (the Bronx, Brooklyn, Manhattan, Queens, and Staten Island), Long Island, and Westchester.
Maximum Out-of-Pocket (Individual)
Platinum Leaf $4,000
Platinum Leaf Premier $5,000
Maximum Out-of-Pocket (Family)
Platinum Leaf $8,000
Platinum Leaf Premier $10,000
Your Annual Checkup
Platinum Leaf $0 copay
Platinum Leaf Premier $0 copay
Primary Care Provider (PCP) Visit
Platinum Leaf $15 copay
Platinum Leaf Premier $10 copay
Dental Care Adult
Platinum Leaf Not covered
Platinum Leaf Premier $10 copay
Dental Pediatrics (up to Age 19)
Platinum Leaf $15 copay
Platinum Leaf Premier $10 copay
Vision Exams Adult
Platinum Leaf Not covered
Platinum Leaf Premier $10 copay
Vision Exams Pediatrics (up to Age 19)
Platinum Leaf $15 copay
Platinum Leaf Premier $10 copay
Telemedicine (Teladoc Health®)
Platinum Leaf $0 copay
Platinum Leaf Premier $0 copay
Specialist Visit
Platinum Leaf $35 copay
Platinum Leaf Premier $35 copay
Retail Health Clinic
Platinum Leaf $15 copay
Platinum Leaf Premier $10 copay
Urgent Care
Platinum Leaf $55 copay
Platinum Leaf Premier $55 copay
Emergency Room
Platinum Leaf $100 copay
Platinum Leaf Premier $100 copay
Ambulance
Platinum Leaf $100 copay
Platinum Leaf Premier $100 copay
Surgeon
Platinum Leaf $100 copay
Platinum Leaf Premier $175 copay
Outpatient Facility
Platinum Leaf $100 copay
Platinum Leaf Premier $175 copay
Inpatient Hospital Stay
Platinum Leaf $500 copay per admission
Platinum Leaf Premier $1,000 copay per admission

Prescription drug benefits

View our comprehensive and up-to-date prescription drug list (formulary).

Platinum Leaf
Platinum Leaf Premier
Generic Drugs (Tier 1)
Platinum Leaf $10 copay
Platinum Leaf Premier $5 copay
Brand Name Preferred (Tier 2)
Platinum Leaf $30 copay
Platinum Leaf Premier $50 copay
Brand Name Non-Preferred (Tier 3)
Platinum Leaf $60 copay
Platinum Leaf Premier $85 copay
90-Day Mail-Order Supply for Generic (Tier 1)
Platinum Leaf $25 copay
Platinum Leaf Premier $10 copay

Additional benefits

24/7 access to telemedicine with Teladoc Health®

Talk to a doctor any time—for a $0 copay. Connect with board-certified doctors through video chat or phone for prescriptions, help diagnosing and treating non-emergency conditions, and more. Access to dermatologists is also available.

Active&Fit ExerciseRewards™ program

Physical activity is one of the simplest ways to stay healthy, and Healthfirst makes it even more rewarding! With the Active&Fit ExerciseRewards program, you can earn up to $200, and your spouse may earn up to $100, every six months if you visit a qualifying fitness center at least 50 days during the same six-month reward period.

The Active&Fit ExerciseRewards program makes working out affordable, too! For just $28/month, you get access to thousands of participating fitness centers. Premium fitness center options are available for additional monthly fees. Track your activity, monitor your progress, achieve your fitness goals, and so much more!

Plan documents

General plan information

•
•

Prescription drug information

•
  • Comprehensive Drug List (Formulary)
See all plan documents Find member forms

Frequently asked questions

Healthfirst Leaf and Leaf Premier Plans both provide quality health coverage through the NY State of Health Marketplace. The main differences are the dental and vision benefits included and the monthly premium.

  • If you want a lower monthly premium and need dental and vision coverage for children only, a Leaf Plan may be right for you.
  • If you want health coverage that includes dental and vision benefits for both children and adults, a Leaf Premier Plan may be right for you.

Both plans include the same medical coverage. The biggest difference is whether adult dental and vision coverage is included.

  • Leaf Plans
    • Comprehensive health coverage
    • Pediatric dental and vision coverage only (no adult coverage)
    • Lower monthly premium
  • Leaf Premier Plans
    • Comprehensive health coverage
    • Pediatric and adult dental and vision coverage
    • Higher monthly premium

How to choose the right plan

Once you’ve decided between a Leaf Plan and a Leaf Premier Plan, you’ll choose a Platinum, Gold, Silver, or Bronze plan based on your healthcare needs and budget. Each plan offers a different balance between your monthly premium and what you’ll pay when you get care.

  • Platinum plans: Highest monthly premiums, lowest out-of-pocket costs
  • Gold plans: Higher monthly premiums, lower out-of-pocket costs
  • Silver plans: Balanced monthly premiums and out-of-pocket costs (You may also be eligible for extra savings)
  • Bronze plans: Lower monthly premiums, higher out-of-pocket costs

You and your family can enroll in a Healthfirst Leaf or Leaf Premier Plan through the NY State of Health Marketplace. Depending on your household size and income, you may qualify for premium savings or other financial assistance.

How to enroll:

If you’re self-employed and don’t meet the income requirements for Medicaid or an Essential Plan, you can get affordable health coverage with a Healthfirst Leaf or Leaf Premier Plan. These plans offer:

  • Income-based savings (subsidies) to help lower your monthly premium, if you qualify
  • Coverage for pre-existing conditions
  • Comprehensive health coverage
  • A choice of Bronze, Silver, Gold, and Platinum plans

Yes. If you’re a freelancer, independent contractor, or gig worker, you may be eligible for coverage through the NY State of Health Marketplace. You can choose from Healthfirst Leaf and Leaf Premier Plans to find the coverage that best fits your healthcare needs and budget.

Disclaimers

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.

Coverage is provided by Healthfirst PHSP, Inc.
Plans contain exclusions and limitations.

ATENCIÓN: Dispone de servicios de asistencia lingüística y otras ayudas, gratis. Llame al 1-866-305-0408 (TTY 1-888-867-4132).

请注意:您可以免费获得语言协助服务和其他辅助服务。请致电 1-866-305-0408 (TTY 1‑888‑542‑3821)。

Telemedicine (Teladoc Health) 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). If you see an in-network primary care provider (PCP) or specialist through telehealth, either online or by phone, your normal cost-sharing amounts apply.

*Up to $400 during coverage year; up to an additional $200 during coverage year for spouse.

Last update November 1, 2026 @ 3:15 am

Gold Leaf Plan highlights

No-cost annual checkups

Preventive and wellness visits

Hospital, emergency room, and urgent care visits

Lab tests and X-rays

Prescription drug coverage

Maternity and newborn coverage

Optional adult dental and vision coverage

24/7 access to care with telemedicine (Teladoc Health)

Physical, occupational, and speech therapy

Annual gym membership reimbursement*

Costs and plan details

Gold Leaf
Gold Leaf Premier
Gold Leaf Premier Plus
Premium
Monthly premium costs depend on household income and size
Deductible (Individual)
Gold Leaf $1,200
Gold Leaf Premier $1,175
Gold Leaf Premier Plus $950
Deductible (Family)
Gold Leaf $2,400
Gold Leaf Premier $2,350
Gold Leaf Premier Plus $1,900
Eligible Age
Under 65
Under 65
Under 65
Eligible Service Areas
Within New York City’s five boroughs (the Bronx, Brooklyn, Manhattan, Queens, and Staten Island), Long Island, and Westchester.
Maximum Out-of-Pocket (Individual)
Gold Leaf $12,000
Gold Leaf Premier $7,800
Gold Leaf Premier Plus $6,800
Maximum Out-of-Pocket (Family)
Gold Leaf $24,000
Gold Leaf Premier $15,600
Gold Leaf Premier Plus $13,600
Your Annual Checkup
Gold Leaf $0 copay
Gold Leaf Premier $0 copay
Gold Leaf Premier Plus $0 copay
Primary Care Provider (PCP) Visit
Gold Leaf $25 copay after deductible
Gold Leaf Premier $25 copay not subject to deductible
Gold Leaf Premier Plus $30 copay not subject to deductible for first visit (PCP, specialist, outpatient mental health/substance use disorder, chiropractor, allergy, Applied Behavioral Analysis (ABA), or second-opinion visit)
$30 copay after deductible for additional visits
Dental Care Adult
Gold Leaf Not covered
Gold Leaf Premier $25 copay not subject to deductible
Gold Leaf Premier Plus $30 copay not subject to deductible
Dental Pediatrics (up to Age 19)
Gold Leaf $25 copay after deductible
Gold Leaf Premier $25 copay not subject to deductible
Gold Leaf Premier Plus $30 copay not subject to deductible
Vision Exams Adult
Gold Leaf Not covered
Gold Leaf Premier $25 copay after deductible
Gold Leaf Premier Plus $30 copay after deductible
Vision Exams Pediatrics (up to Age 19)
Gold Leaf $25 copay after deductible
Gold Leaf Premier $25 copay after deductible
Gold Leaf Premier Plus $30 copay after deductible
Telemedicine (Teladoc Health®)
Gold Leaf $0 copay
Gold Leaf Premier $0 copay
Gold Leaf Premier Plus $0 copay
Specialist Visit
Gold Leaf $40 copay after deductible
Gold Leaf Premier $45 copay after deductible
Gold Leaf Premier Plus $45 copay not subject to deductible for first visit (PCP, specialist, outpatient mental health/substance use disorder, chiropractor, allergy, Applied Behavioral Analysis (ABA), or second-opinion visit)
$40 copay after deductible for additional visits
Retail Health Clinic
Gold Leaf $25 copay after deductible
Gold Leaf Premier $25 copay not subject to deductible
Gold Leaf Premier Plus $30 copay not subject to deductible
Urgent Care
Gold Leaf $60 copay after deductible
Gold Leaf Premier $60 copay after deductible
Gold Leaf Premier Plus $60 copay after deductible
Emergency Room
Gold Leaf $150 copay after deductible
Gold Leaf Premier $175 copay after deductible
Gold Leaf Premier Plus $250 copay after deductible
Ambulance
Gold Leaf $150 copay after deductible
Gold Leaf Premier $150 copay after deductible
Gold Leaf Premier Plus $150 copay after deductible
Surgeon
Gold Leaf $100 copay after deductible
Gold Leaf Premier $200 copay after deductible
Gold Leaf Premier Plus $225 copay after deductible
Outpatient Facility
Gold Leaf $100 copay after deductible
Gold Leaf Premier $200 copay after deductible
Gold Leaf Premier Plus $225 copay after deductible
Inpatient Hospital Stay
Gold Leaf $1,000 copay after deductible per admission
Gold Leaf Premier $1,000 copay after deductible per admission
Gold Leaf Premier Plus $1,000 copay after deductible per admission

Prescription drug benefits

View our comprehensive and up-to-date prescription drug list (formulary).

Gold Leaf
Gold Leaf Premier
Gold Leaf Premier Plus
Generic Drugs (Tier 1)
Gold Leaf $10 copay
Gold Leaf Premier $7 copay
Gold Leaf Premier Plus $10 copay
Brand Name Preferred (Tier 2)
Gold Leaf $35 copay
Gold Leaf Premier $50 copay
Gold Leaf Premier Plus $50 copay
Brand Name Non-Preferred (Tier 3)
Gold Leaf $70 copay
Gold Leaf Premier $100 copay
Gold Leaf Premier Plus $100 copay
90-Day Mail-Order Supply for Generic (Tier 1)
Gold Leaf $25 copay
Gold Leaf Premier $14 copay
Gold Leaf Premier Plus $20 copay

Additional benefits

24/7 access to telemedicine with Teladoc Health®

Talk to a doctor any time—for a $0 copay. Connect with board-certified doctors through video chat or phone for prescriptions, help diagnosing and treating non-emergency conditions, and more. Access to dermatologists is also available.

Active&Fit ExerciseRewards™ program

Physical activity is one of the simplest ways to stay healthy, and Healthfirst makes it even more rewarding! With the Active&Fit ExerciseRewards program, you can earn up to $200, and your spouse may earn up to $100, every six months if you visit a qualifying fitness center at least 50 days during the same six-month reward period.

The Active&Fit ExerciseRewards program makes working out affordable, too! For just $28/month, you get access to thousands of participating fitness centers. Premium fitness center options are available for additional monthly fees. Track your activity, monitor your progress, achieve your fitness goals, and so much more!

Plan documents

General plan information

•
•
•

Prescription drug information

•
  • Comprehensive Drug List (Formulary)
See all plan documents Find member forms

Frequently asked questions

Healthfirst Leaf and Leaf Premier Plans both provide quality health coverage through the NY State of Health Marketplace. The main differences are the dental and vision benefits included and the monthly premium.

  • If you want a lower monthly premium and need dental and vision coverage for children only, a Leaf Plan may be right for you.
  • If you want health coverage that includes dental and vision benefits for both children and adults, a Leaf Premier Plan may be right for you.

Both plans include the same medical coverage. The biggest difference is whether adult dental and vision coverage is included.

  • Leaf Plans
    • Comprehensive health coverage
    • Pediatric dental and vision coverage only (no adult coverage)
    • Lower monthly premium
  • Leaf Premier Plans
    • Comprehensive health coverage
    • Pediatric and adult dental and vision coverage
    • Higher monthly premium

How to choose the right plan

Once you’ve decided between a Leaf Plan and a Leaf Premier Plan, you’ll choose a Platinum, Gold, Silver, or Bronze plan based on your healthcare needs and budget. Each plan offers a different balance between your monthly premium and what you’ll pay when you get care.

  • Platinum plans: Highest monthly premiums, lowest out-of-pocket costs
  • Gold plans: Higher monthly premiums, lower out-of-pocket costs
  • Silver plans: Balanced monthly premiums and out-of-pocket costs (You may also be eligible for extra savings)
  • Bronze plans: Lower monthly premiums, higher out-of-pocket costs

You and your family can enroll in a Healthfirst Leaf or Leaf Premier Plan through the NY State of Health Marketplace. Depending on your household size and income, you may qualify for premium savings or other financial assistance.

How to enroll:

If you’re self-employed and don’t meet the income requirements for Medicaid or an Essential Plan, you can get affordable health coverage with a Healthfirst Leaf or Leaf Premier Plan. These plans offer:

  • Income-based savings (subsidies) to help lower your monthly premium, if you qualify
  • Coverage for pre-existing conditions
  • Comprehensive health coverage
  • A choice of Bronze, Silver, Gold, and Platinum plans

Yes. If you’re a freelancer, independent contractor, or gig worker, you may be eligible for coverage through the NY State of Health Marketplace. You can choose from Healthfirst Leaf and Leaf Premier Plans to find the coverage that best fits your healthcare needs and budget.

Disclaimers

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.

Coverage is provided by Healthfirst PHSP, Inc.
Plans contain exclusions and limitations.

ATENCIÓN: Dispone de servicios de asistencia lingüística y otras ayudas, gratis. Llame al 1-866-305-0408 (TTY 1-888-867-4132).

请注意:您可以免费获得语言协助服务和其他辅助服务。请致电 1-866-305-0408 (TTY 1‑888‑542‑3821)。

Telemedicine (Teladoc Health) 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). If you see an in-network primary care provider (PCP) or specialist through telehealth, either online or by phone, your normal cost-sharing amounts apply.

*Up to $400 during coverage year; up to an additional $200 during coverage year for spouse.

Last update November 1, 2026 @ 3:15 am

2027 plan highlights

No-cost annual checkups

Preventive and wellness visits

Hospital, emergency room, and urgent care visits

Lab tests and X-rays

Prescription drug coverage

Maternity and newborn coverage

Optional adult dental and vision coverage

24/7 access to care with telemedicine (Teladoc Health)

Physical, occupational, and speech therapy

Annual gym membership reimbursement*

Costs and plan details

Silver Leaf
Silver Leaf Premier
Silver Leaf Premier Plus
Premium
Monthly premium costs depend on household income and size
Eligible Age
Under 65
Eligible Service Areas
Within New York City’s five boroughs (the Bronx, Brooklyn, Manhattan, Queens, and Staten Island), Long Island, and Westchester.
Deductible (individual)
Maximum Out-of-Pocket (individual)
Deductible (Family)
Maximum Out-of-Pocket (Family)
Your Annual Checkup
Primary Care Provider (PCP) Visit
Dental Care Adult
Dental Pediatrics (up to Age 19)
Vision Exams Adult
Vision Exams Pediatrics (up to Age 19)
Telemedicine (Teladoc)
Specialist Visit
Retail Health Clinic
Urgent Care
Emergency Room
Ambulance
Surgeon
Outpatient Facility
Inpatient Hospital Stay

Prescription drug benefits

View our comprehensive and up-to-date prescription drug list (formulary).

Silver Leaf
Silver Leaf Premier
Silver Leaf Premier Plus
Generic Drugs (Tier 1)
Brand Name Preferred (Tier 2)
Brand Name Non-Preferred (Tier 3)
90-Day Mail-Order Supply for Generic (Tier 1)

Additional benefits

24/7 access to telemedicine with Teladoc Health®

Talk to a doctor any time—for a $0 copay. Connect with board-certified doctors through video chat or phone for prescriptions, help diagnosing and treating non-emergency conditions, and more. Access to dermatologists is also available.

Active&Fit ExerciseRewards™ program

Physical activity is one of the simplest ways to stay healthy, and Healthfirst makes it even more rewarding! With the Active&Fit ExerciseRewards program, you can earn up to $200, and your spouse may earn up to $100, every six months if you visit a qualifying fitness center at least 50 days during the same six-month reward period.

The Active&Fit ExerciseRewards program makes working out affordable, too! For just $28/month, you get access to thousands of participating fitness centers. Premium fitness center options are available for additional monthly fees. Track your activity, monitor your progress, achieve your fitness goals, and so much more!

Plan documents

General plan information

•
  • Federal Poverty Guidelines
•
  • Summary of Benefits and Coverage - Silver Leaf Premier Plus (>400% FPL)
•
  • Summary of Benefits and Coverage - Silver Leaf Premier Plus (350 - 400% FPL)
•
  • Summary of Benefits and Coverage - Silver Leaf Premier Plus (150 - 350% FPL)
•
  • Summary of Benefits and Coverage - Silver Leaf Premier Plus (100 - 150% FPL)
•
•
  • Summary of Benefits and Coverage - Silver Leaf Premier (350 - 400% FPL)
•
  • Summary of Benefits and Coverage - Silver Leaf Premier (150 - 350% FPL)
•
  • Summary of Benefits and Coverage - Silver Leaf Premier (100 - 150% FPL)
•
•
•
•

Prescription drug information

•
  • Comprehensive Formulary (List of Covered Drugs)

Disclaimers

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.

Coverage is provided by Healthfirst PHSP, Inc.
Plans contain exclusions and limitations.

ATENCIÓN: Dispone de servicios de asistencia lingüística y otras ayudas, gratis. Llame al 1-866-305-0408 (TTY 1-888-867-4132).

请注意:您可以免费获得语言协助服务和其他辅助服务。请致电 1-866-305-0408 (TTY 1‑888‑542‑3821)。

Telemedicine (Teladoc Health) 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). If you see an in-network primary care provider (PCP) or specialist through telehealth, either online or by phone, your normal cost-sharing amounts apply.

*Up to $400 during coverage year; up to an additional $200 during coverage year for spouse.

Last update November 1, 2026 @ 3:15 am

Silver Leaf 100-150 Plan Highlights

No-cost annual checkups

Preventive and wellness visits

Hospital, emergency room, and urgent care visits

Lab tests and X-rays

Prescription drug coverage

Maternity and newborn coverage

Optional adult dental and vision coverage

24/7 access to care with telemedicine (Teladoc Health)

Physical, occupational, and speech therapy

Annual gym membership reimbursement*

Costs and plan details

Silver Leaf 100-150
Silver Leaf Premier 100-150
Silver Leaf Premier Plus 100-150
Premium
Monthly premium costs depend on household income and size
Deductible (Individual)
Silver Leaf 100-150 $125
Silver Leaf Premier 100-150 $125
Silver Leaf Premier Plus 100-150 $125
Deductible (Family)
Silver Leaf 100-150 $250
Silver Leaf Premier 100-150 $250
Silver Leaf Premier Plus 100-150 $250
Eligible Age
Under 65
Under 65
Under 65
Eligible Service Areas
Within New York City’s five boroughs (the Bronx, Brooklyn, Manhattan, Queens, and Staten Island), Long Island, and Westchester.
Maximum Out-of-Pocket (Individual)
Silver Leaf 100-150 $4,000
Silver Leaf Premier 100-150 $2,100
Silver Leaf Premier Plus 100-150 $2,000
Maximum Out-of-Pocket (Family)
Silver Leaf 100-150 $8,000
Silver Leaf Premier 100-150 $4,200
Silver Leaf Premier Plus 100-150 $4,000
Your Annual Checkup
Silver Leaf 100-150 $0 copay
Silver Leaf Premier 100-150 $0 copay
Silver Leaf Premier Plus 100-150 $0 copay
Primary Care Provider (PCP) Visit
Silver Leaf 100-150 $10 copay not subject to deductible for first visit (PCP, specialist, outpatient mental health/substance use disorder, chiropractor, allergy, Applied Behavioral Analysis (ABA), or second-opinion visit)
$10 copay after deductible for additional visits
Silver Leaf Premier 100-150 $10 copay after deductible
Silver Leaf Premier Plus 100-150 $10 copay not subject to deductible for first visit (PCP, specialist, outpatient mental health/substance use disorder, chiropractor, allergy, Applied Behavioral Analysis (ABA), or second-opinion visit)
$10 copay after deductible for additional visits
Dental Care Adult
Silver Leaf 100-150 not covered
Silver Leaf Premier 100-150 $10 copay
Silver Leaf Premier Plus 100-150 $10 copay
Dental Pediatrics (up to Age 19)
Silver Leaf 100-150 $10 copay
Silver Leaf Premier 100-150 $10 copay
Silver Leaf Premier Plus 100-150 $10 copay
Vision Exams Adult
Silver Leaf 100-150 not covered
Silver Leaf Premier 100-150 $10 copay after deductible
Silver Leaf Premier Plus 100-150 $10 copay after deductible
Vision Exams Pediatrics (up to Age 19)
Silver Leaf 100-150 $10 copay after deductible
Silver Leaf Premier 100-150 $10 copay after deductible
Silver Leaf Premier Plus 100-150 $10 copay after deductible
Telemedicine (Teladoc Health®)
Silver Leaf 100-150 $0 copay
Silver Leaf Premier 100-150 $0 copay
Silver Leaf Premier Plus 100-150 $0 copay
Specialist Visit
Silver Leaf 100-150 $20 copay not subject to deductible for first visit (PCP, specialist, outpatient mental health/substance use disorder, chiropractor, allergy, Applied Behavioral Analysis (ABA), or second-opinion visit)
$20 copay after deductible for additional visits
Silver Leaf Premier 100-150 $20 copay after deductible
Silver Leaf Premier Plus 100-150 $20 copay not subject to deductible for first visit (PCP, specialist, outpatient mental health/substance use disorder, chiropractor, allergy, Applied Behavioral Analysis (ABA), or second-opinion visit)
$20 copay after deductible for additional visits
Retail Health Clinic
Silver Leaf 100-150 $10 copay after deductible
Silver Leaf Premier 100-150 $10 copay after deductible
Silver Leaf Premier Plus 100-150 $10 copay after deductible
Urgent Care
Silver Leaf 100-150 $30 copay after deductible
Silver Leaf Premier 100-150 $30 copay after deductible
Silver Leaf Premier Plus 100-150 $30 copay after deductible
Emergency Room
Silver Leaf 100-150 $50 copay after deductible
Silver Leaf Premier 100-150 $50 copay after deductible
Silver Leaf Premier Plus 100-150 $100 copay after deductible
Ambulance
Silver Leaf 100-150 $50 copay after deductible
Silver Leaf Premier 100-150 $150 copay after deductible
Silver Leaf Premier Plus 100-150 $150 copay after deductible
Surgeon
Silver Leaf 100-150 $25 copay after deductible
Silver Leaf Premier 100-150 $100 after deductible
Silver Leaf Premier Plus 100-150 $50 after deductible
Outpatient Facility
Silver Leaf 100-150 $25 copay
Silver Leaf Premier 100-150 $100 copay after deductible
Silver Leaf Premier Plus 100-150 $50 copay after deductible
Inpatient Hospital Stay
Silver Leaf 100-150 $100 copay per admission
Silver Leaf Premier 100-150 $100 copay per admission
Silver Leaf Premier Plus 100-150 $300 copay per admission after deductible

Prescription drug benefits

View our comprehensive and up-to-date prescription drug list (formulary).

Silver Leaf 100-150
Silver Leaf Premier 100-150
Silver Leaf Premier Plus 100-150
Generic Drugs (Tier 1)
Silver Leaf 100-150 $6 copay
Silver Leaf Premier 100-150 $6 copay
Silver Leaf Premier Plus 100-150 $10 copay
Brand Name Preferred (Tier 2)
Silver Leaf 100-150 $15 copay
Silver Leaf Premier 100-150 $40 copay
Silver Leaf Premier Plus 100-150 $55 copay
Brand Name Non-Preferred (Tier 3)
Silver Leaf 100-150 $30 copay
Silver Leaf Premier 100-150 30% coinsurance after deductible
Silver Leaf Premier Plus 100-150 30% coinsurance after deductible
90-Day Mail-Order Supply for Generic (Tier 1)
Silver Leaf 100-150 $15 copay
Silver Leaf Premier 100-150 $12 copay
Silver Leaf Premier Plus 100-150 $20 copay

Additional benefits

24/7 access to telemedicine with Teladoc Health®

Talk to a doctor any time—for a $0 copay. Connect with board-certified doctors through video chat or phone for prescriptions, help diagnosing and treating non-emergency conditions, and more. Access to dermatologists is also available.

Active&Fit ExerciseRewards™ program

Physical activity is one of the simplest ways to stay healthy, and Healthfirst makes it even more rewarding! With the Active&Fit ExerciseRewards program, you can earn up to $200, and your spouse may earn up to $100, every six months if you visit a qualifying fitness center at least 50 days during the same six-month reward period.

The Active&Fit ExerciseRewards program makes working out affordable, too! For just $28/month, you get access to thousands of participating fitness centers. Premium fitness center options are available for additional monthly fees. Track your activity, monitor your progress, achieve your fitness goals, and so much more!

Plan documents

General plan information

•
  • Federal Poverty Guidelines
•
•
•

Prescription drug information

•
  • Comprehensive Formulary (List of Covered Drugs)
See all plan documents Find member forms

Frequently asked questions

Healthfirst Leaf and Leaf Premier Plans both provide quality health coverage through the NY State of Health Marketplace. The main differences are the dental and vision benefits included and the monthly premium.

  • If you want a lower monthly premium and need dental and vision coverage for children only, a Leaf Plan may be right for you.
  • If you want health coverage that includes dental and vision benefits for both children and adults, a Leaf Premier Plan may be right for you.

Both plans include the same medical coverage. The biggest difference is whether adult dental and vision coverage is included.

  • Leaf Plans
    • Comprehensive health coverage
    • Pediatric dental and vision coverage only (no adult coverage)
    • Lower monthly premium
  • Leaf Premier Plans
    • Comprehensive health coverage
    • Pediatric and adult dental and vision coverage
    • Higher monthly premium

How to choose the right plan

Once you’ve decided between a Leaf Plan and a Leaf Premier Plan, you’ll choose a Platinum, Gold, Silver, or Bronze plan based on your healthcare needs and budget. Each plan offers a different balance between your monthly premium and what you’ll pay when you get care.

  • Platinum plans: Highest monthly premiums, lowest out-of-pocket costs
  • Gold plans: Higher monthly premiums, lower out-of-pocket costs
  • Silver plans: Balanced monthly premiums and out-of-pocket costs (You may also be eligible for extra savings)
  • Bronze plans: Lower monthly premiums, higher out-of-pocket costs

You and your family can enroll in a Healthfirst Leaf or Leaf Premier Plan through the NY State of Health Marketplace. Depending on your household size and income, you may qualify for premium savings or other financial assistance.

How to enroll:

If you’re self-employed and don’t meet the income requirements for Medicaid or an Essential Plan, you can get affordable health coverage with a Healthfirst Leaf or Leaf Premier Plan. These plans offer:

  • Income-based savings (subsidies) to help lower your monthly premium, if you qualify
  • Coverage for pre-existing conditions
  • Comprehensive health coverage
  • A choice of Bronze, Silver, Gold, and Platinum plans

Yes. If you’re a freelancer, independent contractor, or gig worker, you may be eligible for coverage through the NY State of Health Marketplace. You can choose from Healthfirst Leaf and Leaf Premier Plans to find the coverage that best fits your healthcare needs and budget.

Disclaimers

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.

Coverage is provided by Healthfirst PHSP, Inc.
Plans contain exclusions and limitations.

ATENCIÓN: Dispone de servicios de asistencia lingüística y otras ayudas, gratis. Llame al 1-866-305-0408 (TTY 1-888-867-4132).

请注意:您可以免费获得语言协助服务和其他辅助服务。请致电 1-866-305-0408 (TTY 1‑888‑542‑3821)。

Telemedicine (Teladoc Health) 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). If you see an in-network primary care provider (PCP) or specialist through telehealth, either online or by phone, your normal cost-sharing amounts apply.

*Up to $400 during coverage year; up to an additional $200 during coverage year for spouse.

Last update November 1, 2026 @ 3:15 am

Silver Leaf 150-200 Plan Highlights

No-cost annual checkups

Preventive and wellness visits

Hospital, emergency room, and urgent care visits

Lab tests and X-rays

Prescription drug coverage

Maternity and newborn coverage

Optional adult dental and vision coverage

24/7 access to care with telemedicine (Teladoc Health)

Physical, occupational, and speech therapy

Annual gym membership reimbursement*

Costs and plan details

Silver Leaf 150-200
Silver Leaf Premier 150-200
Silver Leaf Premier Plus 150-200
Premium
Monthly premium costs depend on household income and size
Deductible (Individual)
Silver Leaf 150-200 $575
Silver Leaf Premier 150-200 $250
Silver Leaf Premier Plus 150-200 $250
Deductible (Family)
Silver Leaf 150-200 $1,150
Silver Leaf Premier 150-200 $500
Silver Leaf Premier Plus 150-200 $500
Eligible Age
Under 65
Under 65
Under 65
Eligible Service Areas
Within New York City’s five boroughs (the Bronx, Brooklyn, Manhattan, Queens, and Staten Island), Long Island, and Westchester.
Maximum Out-of-Pocket (Individual)
Silver Leaf 150-200 $4,000
Silver Leaf Premier 150-200 $3,200
Silver Leaf Premier Plus 150-200 $2,800
Maximum Out-of-Pocket (Family)
Silver Leaf 150-200 $8,000
Silver Leaf Premier 150-200 $6,400
Silver Leaf Premier Plus 150-200 $5,600
Your Annual Checkup
Silver Leaf 150-200 $0 copay
Silver Leaf Premier 150-200 $0 copay
Silver Leaf Premier Plus 150-200 $0 copay
Primary Care Provider (PCP) Visit
Silver Leaf 150-200 $15 copay not subject to deductible for first visit (PCP, specialist, outpatient mental health/substance use disorder, chiropractor, allergy, Applied Behavioral Analysis (ABA), or second-opinion visit)
$15 copay after deductible for additional visits
Silver Leaf Premier 150-200 $25 copay
Silver Leaf Premier Plus 150-200 $30 copay not subject to deductible for first visit (PCP, specialist, outpatient mental health/substance use disorder, chiropractor, allergy, Applied Behavioral Analysis (ABA), or second-opinion visit)
$30 copay after deductible for additional visits
Dental Care Adult
Silver Leaf 150-200 not covered
Silver Leaf Premier 150-200 $25 copay not subject to deductible
Silver Leaf Premier Plus 150-200 $30 copay not subject to deductible
Dental Pediatrics (up to Age 19)
Silver Leaf 150-200 $15 copay after deductible
Silver Leaf Premier 150-200 $25 copay not subject to deductible
Silver Leaf Premier Plus 150-200 $30 copay not subject to deductible
Vision Exams Adult
Silver Leaf 150-200 not covered
Silver Leaf Premier 150-200 $25 copay after deductible
Silver Leaf Premier Plus 150-200 $30 copay after deductible
Vision Exams Pediatrics (up to Age 19)
Silver Leaf 150-200 $15 copay after deductible
Silver Leaf Premier 150-200 $25 copay after deductible
Silver Leaf Premier Plus 150-200 $30 copay after deductible
Telemedicine (Teladoc Health®)
Silver Leaf 150-200 $0 copay
Silver Leaf Premier 150-200 $0 copay
Silver Leaf Premier Plus 150-200 $0 copay
Specialist Visit
Silver Leaf 150-200 $35 copay not subject to deductible for first visit (PCP, specialist, outpatient mental health/substance use disorder, chiropractor, allergy, Applied Behavioral Analysis (ABA), or second-opinion visit)
$35 copay after deductible for additional visits
Silver Leaf Premier 150-200 $50 copay after deductible
Silver Leaf Premier Plus 150-200 $60 copay not subject to deductible for first visit (PCP, specialist, outpatient mental health/substance use disorder, chiropractor, allergy, Applied Behavioral Analysis (ABA), or second-opinion visit)
$60 copay after deductible for additional visits
Retail Health Clinic
Silver Leaf 150-200 $15 copay after deductible
Silver Leaf Premier 150-200 $25 copay not subject to deductible
Silver Leaf Premier Plus 150-200 $30 copay not subject to deductible
Urgent Care
Silver Leaf 150-200 $50 copay after deductible
Silver Leaf Premier 150-200 $70 copay after deductible
Silver Leaf Premier Plus 150-200 $70 copay after deductible
Emergency Room
Silver Leaf 150-200 $75 copay after deductible
Silver Leaf Premier 150-200 $250 copay after deductible
Silver Leaf Premier Plus 150-200 $500 copay after deductible
Ambulance
Silver Leaf 150-200 $75 copay after deductible
Silver Leaf Premier 150-200 $150 copay after deductible
Silver Leaf Premier Plus 150-200 $150 copay after deductible
Surgeon
Silver Leaf 150-200 $75 copay after deductible
Silver Leaf Premier 150-200 $125 copay after deductible
Silver Leaf Premier Plus 150-200 $100 copay after deductible
Outpatient Facility
Silver Leaf 150-200 $75 copay after deductible
Silver Leaf Premier 150-200 $125 copay after deductible
Silver Leaf Premier Plus 150-200 $100 copay after deductible
Inpatient Hospital Stay
Silver Leaf 150-200 $250 copay per admission after deductible
Silver Leaf Premier 150-200 $1,500 copay per admission after deductible
Silver Leaf Premier Plus 150-200 $1,500 copay per admission after deductible

Prescription drug benefits

View our comprehensive and up-to-date prescription drug list (formulary).

Silver Leaf 150-200
Silver Leaf Premier 150-200
Silver Leaf Premier Plus 150-200
Generic Drugs (Tier 1)
Silver Leaf 150-200 $9 copay not subject to deductible
Silver Leaf Premier 150-200 $10 copay not subject to deductible
Silver Leaf Premier Plus 150-200 $15 copay not subject to deductible
Brand Name Preferred (Tier 2)
Silver Leaf 150-200 $20 copay not subject to deductible
Silver Leaf Premier 150-200 $55 copay not subject to deductible
Silver Leaf Premier Plus 150-200 $55 copay not subject to deductible
Brand Name Non-Preferred (Tier 3)
Silver Leaf 150-200 $40 copay not subject to deductible
Silver Leaf Premier 150-200 35% coinsurance after deductible
Silver Leaf Premier Plus 150-200 35% coinsurance after deductible
90-Day Mail-Order Supply for Generic (Tier 1)
Silver Leaf 150-200 $22.50 copay
Silver Leaf Premier 150-200 $20 copay
Silver Leaf Premier Plus 150-200 $30 copay

Additional benefits

24/7 access to telemedicine with Teladoc Health®

Talk to a doctor any time—for a $0 copay. Connect with board-certified doctors through video chat or phone for prescriptions, help diagnosing and treating non-emergency conditions, and more. Access to dermatologists is also available.

Active&Fit ExerciseRewards™ program

Physical activity is one of the simplest ways to stay healthy, and Healthfirst makes it even more rewarding! With the Active&Fit ExerciseRewards program, you can earn up to $200, and your spouse may earn up to $100, every six months if you visit a qualifying fitness center at least 50 days during the same six-month reward period.

The Active&Fit ExerciseRewards program makes working out affordable, too! For just $28/month, you get access to thousands of participating fitness centers. Premium fitness center options are available for additional monthly fees. Track your activity, monitor your progress, achieve your fitness goals, and so much more!

Plan documents

General plan information

•
  • Federal Poverty Guidelines
•
•
•

Prescription drug information

•
  • Comprehensive Formulary (List of Covered Drugs)
Find member forms

Frequently asked questions

Healthfirst Leaf and Leaf Premier Plans both provide quality health coverage through the NY State of Health Marketplace. The main differences are the dental and vision benefits included and the monthly premium.

  • If you want a lower monthly premium and need dental and vision coverage for children only, a Leaf Plan may be right for you.
  • If you want health coverage that includes dental and vision benefits for both children and adults, a Leaf Premier Plan may be right for you.

Both plans include the same medical coverage. The biggest difference is whether adult dental and vision coverage is included.

  • Leaf Plans
    • Comprehensive health coverage
    • Pediatric dental and vision coverage only (no adult coverage)
    • Lower monthly premium
  • Leaf Premier Plans
    • Comprehensive health coverage
    • Pediatric and adult dental and vision coverage
    • Higher monthly premium

How to choose the right plan

Once you’ve decided between a Leaf Plan and a Leaf Premier Plan, you’ll choose a Platinum, Gold, Silver, or Bronze plan based on your healthcare needs and budget. Each plan offers a different balance between your monthly premium and what you’ll pay when you get care.

  • Platinum plans: Highest monthly premiums, lowest out-of-pocket costs
  • Gold plans: Higher monthly premiums, lower out-of-pocket costs
  • Silver plans: Balanced monthly premiums and out-of-pocket costs (You may also be eligible for extra savings)
  • Bronze plans: Lower monthly premiums, higher out-of-pocket costs

You and your family can enroll in a Healthfirst Leaf or Leaf Premier Plan through the NY State of Health Marketplace. Depending on your household size and income, you may qualify for premium savings or other financial assistance.

How to enroll:

If you’re self-employed and don’t meet the income requirements for Medicaid or an Essential Plan, you can get affordable health coverage with a Healthfirst Leaf or Leaf Premier Plan. These plans offer:

  • Income-based savings (subsidies) to help lower your monthly premium, if you qualify
  • Coverage for pre-existing conditions
  • Comprehensive health coverage
  • A choice of Bronze, Silver, Gold, and Platinum plans

Yes. If you’re a freelancer, independent contractor, or gig worker, you may be eligible for coverage through the NY State of Health Marketplace. You can choose from Healthfirst Leaf and Leaf Premier Plans to find the coverage that best fits your healthcare needs and budget.

Disclaimers

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.

Coverage is provided by Healthfirst PHSP, Inc.
Plans contain exclusions and limitations.

ATENCIÓN: Dispone de servicios de asistencia lingüística y otras ayudas, gratis. Llame al 1-866-305-0408 (TTY 1-888-867-4132).

请注意:您可以免费获得语言协助服务和其他辅助服务。请致电 1-866-305-0408 (TTY 1‑888‑542‑3821)。

Telemedicine (Teladoc Health) 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). If you see an in-network primary care provider (PCP) or specialist through telehealth, either online or by phone, your normal cost-sharing amounts apply.

*Up to $400 during coverage year; up to an additional $200 during coverage year for spouse.

Last update November 1, 2026 @ 3:15 am

Silver Leaf 200-250 Plan Highlights

No-cost annual checkups

Preventive and wellness visits

Hospital, emergency room, and urgent care visits

Lab tests and X-rays

Prescription drug coverage

Maternity and newborn coverage

Optional adult dental and vision coverage

24/7 access to care with telemedicine (Teladoc Health)

Physical, occupational, and speech therapy

Annual gym membership reimbursement*

Costs and plan details

Silver Leaf 200-250
Silver Leaf Premier 200-250
Silver Leaf Premier Plus 200-250
Premium
Monthly premium costs depend on household income and size
Deductible (Individual)
Silver Leaf 200-250 $3,050
Silver Leaf Premier 200-250 $4,250
Silver Leaf Premier Plus 200-250 $2,160
Deductible (Family)
Silver Leaf 200-250 $6,100
Silver Leaf Premier 200-250 $8,500
Silver Leaf Premier Plus 200-250 $4,320
Eligible Age
Under 65
Under 65
Under 65
Eligible Service Areas
Within New York City’s five boroughs (the Bronx, Brooklyn, Manhattan, Queens, and Staten Island), Long Island, and Westchester.
Maximum Out-of-Pocket (Individual)
Silver Leaf 200-250 $9,600
Silver Leaf Premier 200-250 $8,900
Silver Leaf Premier Plus 200-250 $8,600
Maximum Out-of-Pocket (Family)
Silver Leaf 200-250 $19,200
Silver Leaf Premier 200-250 $17,800
Silver Leaf Premier Plus 200-250 $17,200
Your Annual Checkup
Silver Leaf 200-250 $0 copay
Silver Leaf Premier 200-250 $0 copay
Silver Leaf Premier Plus 200-250 $0 copay
Primary Care Provider (PCP) Visit
Silver Leaf 200-250 $30 copay not subject to deductible for the first visit (PCP, specialist, outpatient mental health/substance use disorder, chiropractor, allergy, Applied Behavioral Analysis (ABA), or second-opinion visit)
$30 copay after deductible for additional visits
Silver Leaf Premier 200-250 $35 copay not subject to deductible
Silver Leaf Premier Plus 200-250 $35 copay not subject to deductible for the first visit (PCP, specialist, outpatient mental health/substance use disorder, chiropractor, allergy, Applied Behavioral Analysis (ABA), or second-opinion visit)
$30 copay after deductible for additional visits
Dental Care Adult
Silver Leaf 200-250 not covered
Silver Leaf Premier 200-250 $35 copay not subject to deductible
Silver Leaf Premier Plus 200-250 $35 copay not subject to deductible
Dental Pediatrics (up to Age 19)
Silver Leaf 200-250 $30 copay after deductible
Silver Leaf Premier 200-250 $35 copay not subject to deductible
Silver Leaf Premier Plus 200-250 $35 copay not subject to deductible
Vision Exams Adult
Silver Leaf 200-250 not covered
Silver Leaf Premier 200-250 $35 copay after deductible
Silver Leaf Premier Plus 200-250 $35 copay after deductible
Vision Exams Pediatrics (up to Age 19)
Silver Leaf 200-250 $30 copay after deductible
Silver Leaf Premier 200-250 $35 copay after deductible
Silver Leaf Premier Plus 200-250 $35 copay after deductible
Telemedicine (Teladoc Health®)
Silver Leaf 200-250 $0 copay
Silver Leaf Premier 200-250 $0 copay
Silver Leaf Premier Plus 200-250 $0 copay
Specialist Visit
Silver Leaf 200-250 $65 copay not subject to deductible for the first visit (PCP, specialist, outpatient mental health/substance use disorder, chiropractor, allergy, Applied Behavioral Analysis (ABA), or second-opinion visit)
$65 copay after deductible for additional visits
Silver Leaf Premier 200-250 $55 copay after deductible
Silver Leaf Premier Plus 200-250 $70 copay not subject to deductible for the first visit (PCP, specialist, outpatient mental health/substance use disorder, chiropractor, allergy, Applied Behavioral Analysis (ABA), or second-opinion visit)
$70 copay after deductible for additional visits
Retail Health Clinic
Silver Leaf 200-250 $30 copay after deductible
Silver Leaf Premier 200-250 $35 copayment not subject to deductible
Silver Leaf Premier Plus 200-250 $35 copay not subject to deductible
Urgent Care
Silver Leaf 200-250 $70 copay after deductible
Silver Leaf Premier 200-250 $70 copay after deductible
Silver Leaf Premier Plus 200-250 $70 copay after deductible
Emergency Room
Silver Leaf 200-250 $275 copay after deductible
Silver Leaf Premier 200-250 $550 copay after deductible
Silver Leaf Premier Plus 200-250 $750 copay after deductible
Ambulance
Silver Leaf 200-250 $150 copay after deductible
Silver Leaf Premier 200-250 $150 copay after deductible
Silver Leaf Premier Plus 200-250 $150 copay after deductible
Surgeon
Silver Leaf 200-250 $150 copay after deductible
Silver Leaf Premier 200-250 $250 copay after deductible
Silver Leaf Premier Plus 200-250 $250 copay after deductible
Outpatient Facility
Silver Leaf 200-250 $150 copay after deductible
Silver Leaf Premier 200-250 $250 copay after deductible
Silver Leaf Premier Plus 200-250 $250 copay after deductible
Inpatient Hospital Stay
Silver Leaf 200-250 $1,500 copay per admission after deductible
Silver Leaf Premier 200-250 $1,500 copay per admission after deductible
Silver Leaf Premier Plus 200-250 $2,050 copay per admission after deductible

Prescription drug benefits

View our comprehensive and up-to-date prescription drug list (formulary).

Silver Leaf 200-250
Silver Leaf Premier 200-250
Silver Leaf Premier Plus 200-250
Generic Drugs (Tier 1)
Silver Leaf 200-250 $15 copay not subject to deductible
Silver Leaf Premier 200-250 $10 copay not subject to deductible
Silver Leaf Premier Plus 200-250 $15 copay not subject to deductible
Brand Name Preferred (Tier 2)
Silver Leaf 200-250 $40 copay not subject to deductible
Silver Leaf Premier 200-250 $55 copay not subject to deductible
Silver Leaf Premier Plus 200-250 $55 copay not subject to deductible
Brand Name Non-Preferred (Tier 3)
Silver Leaf 200-250 $75 copay not subject to deductible
Silver Leaf Premier 200-250 40% coinsurance after deductible
Silver Leaf Premier Plus 200-250 40% coinsurance after deductible
90-Day Mail-Order Supply for Generic (Tier 1)
Silver Leaf 200-250 $37.50 copay not subject to deductible
Silver Leaf Premier 200-250 $20 copay not subject to deductible
Silver Leaf Premier Plus 200-250 $30 copay not subject to deductible

Additional benefits

24/7 access to telemedicine with Teladoc Health®

Talk to a doctor any time—for a $0 copay. Connect with board-certified doctors through video chat or phone for prescriptions, help diagnosing and treating non-emergency conditions, and more. Access to dermatologists is also available.

Active&Fit ExerciseRewards™ program

Physical activity is one of the simplest ways to stay healthy, and Healthfirst makes it even more rewarding! With the Active&Fit ExerciseRewards program, you can earn up to $200, and your spouse may earn up to $100, every six months if you visit a qualifying fitness center at least 50 days during the same six-month reward period.

The Active&Fit ExerciseRewards program makes working out affordable, too! For just $28/month, you get access to thousands of participating fitness centers. Premium fitness center options are available for additional monthly fees. Track your activity, monitor your progress, achieve your fitness goals, and so much more!

Plan documents

General plan information

•
  • Federal Poverty Guidelines
•
•
•

Prescription drug information

•
  • Comprehensive Formulary (List of Covered Drugs)
See all plan documents Find member forms

Frequently asked questions

Healthfirst Leaf and Leaf Premier Plans both provide quality health coverage through the NY State of Health Marketplace. The main differences are the dental and vision benefits included and the monthly premium.

  • If you want a lower monthly premium and need dental and vision coverage for children only, a Leaf Plan may be right for you.
  • If you want health coverage that includes dental and vision benefits for both children and adults, a Leaf Premier Plan may be right for you.

Both plans include the same medical coverage. The biggest difference is whether adult dental and vision coverage is included.

  • Leaf Plans
    • Comprehensive health coverage
    • Pediatric dental and vision coverage only (no adult coverage)
    • Lower monthly premium
  • Leaf Premier Plans
    • Comprehensive health coverage
    • Pediatric and adult dental and vision coverage
    • Higher monthly premium

How to choose the right plan

Once you’ve decided between a Leaf Plan and a Leaf Premier Plan, you’ll choose a Platinum, Gold, Silver, or Bronze plan based on your healthcare needs and budget. Each plan offers a different balance between your monthly premium and what you’ll pay when you get care.

  • Platinum plans: Highest monthly premiums, lowest out-of-pocket costs
  • Gold plans: Higher monthly premiums, lower out-of-pocket costs
  • Silver plans: Balanced monthly premiums and out-of-pocket costs (You may also be eligible for extra savings)
  • Bronze plans: Lower monthly premiums, higher out-of-pocket costs

You and your family can enroll in a Healthfirst Leaf or Leaf Premier Plan through the NY State of Health Marketplace. Depending on your household size and income, you may qualify for premium savings or other financial assistance.

How to enroll:

If you’re self-employed and don’t meet the income requirements for Medicaid or an Essential Plan, you can get affordable health coverage with a Healthfirst Leaf or Leaf Premier Plan. These plans offer:

  • Income-based savings (subsidies) to help lower your monthly premium, if you qualify
  • Coverage for pre-existing conditions
  • Comprehensive health coverage
  • A choice of Bronze, Silver, Gold, and Platinum plans

Yes. If you’re a freelancer, independent contractor, or gig worker, you may be eligible for coverage through the NY State of Health Marketplace. You can choose from Healthfirst Leaf and Leaf Premier Plans to find the coverage that best fits your healthcare needs and budget.

Disclaimers

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.

Coverage is provided by Healthfirst PHSP, Inc.
Plans contain exclusions and limitations.

ATENCIÓN: Dispone de servicios de asistencia lingüística y otras ayudas, gratis. Llame al 1-866-305-0408 (TTY 1-888-867-4132).

请注意:您可以免费获得语言协助服务和其他辅助服务。请致电 1-866-305-0408 (TTY 1‑888‑542‑3821)。

Telemedicine (Teladoc Health) 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). If you see an in-network primary care provider (PCP) or specialist through telehealth, either online or by phone, your normal cost-sharing amounts apply.

*Up to $400 during coverage year; up to an additional $200 during coverage year for spouse.

Last update November 1, 2026 @ 3:15 am

Silver Leaf Plan highlights

No-cost annual checkups

Preventive and wellness visits

Hospital, emergency room, and urgent care visits

Lab tests and X-rays

Prescription drug coverage

Maternity and newborn coverage

Optional adult dental and vision coverage

24/7 access to care with telemedicine (Teladoc Health)

Physical, occupational, and speech therapy

Annual gym membership reimbursement*

Costs and plan details

Silver Leaf
Silver Leaf Premier
Silver Leaf Premier Plus
Premium
Monthly premium costs depend on household income and size
Deductible (Individual)
Silver Leaf $3,750
Silver Leaf Premier $3,750
Silver Leaf Premier Plus $2,450
Deductible (Family)
Silver Leaf $7,500
Silver Leaf Premier $7,500
Silver Leaf Premier Plus $4,900
Eligible Age
Under 65
Under 65
Under 65
Eligible Service Areas
Within New York City’s five boroughs (the Bronx, Brooklyn, Manhattan, Queens, and Staten Island), Long Island, and Westchester.
Maximum Out-of-Pocket (Individual)
Silver Leaf $12,000
Silver Leaf Premier $10,100
Silver Leaf Premier Plus $10,000
Maximum Out-of-Pocket (Family)
Silver Leaf $24,000
Silver Leaf Premier $20,100
Silver Leaf Premier Plus $20,000
Your Annual Checkup
Silver Leaf $0 copay
Silver Leaf Premier $0 copay
Silver Leaf Premier Plus $0 copay
Primary Care Provider (PCP) Visit
Silver Leaf $30 copay not subject to deductible for the first visit (PCP, specialist, outpatient mental health/substance use disorder, chiropractor, allergy, Applied Behavioral Analysis (ABA), or second-opinion visit)
$30 copay after deductible for additional visits
Silver Leaf Premier $35 copay not subject to deductible
Silver Leaf Premier Plus $30 copay not subject to deductible for the first visit (PCP, specialist, outpatient mental health/substance use disorder, chiropractor, allergy, Applied Behavioral Analysis (ABA), or second-opinion visit)
$30 copay after deductible for additional visits
Dental Care Adult
Silver Leaf not covered
Silver Leaf Premier $35
Silver Leaf Premier Plus $30 copay not subject to deductible
Dental Pediatrics (up to Age 19)
Silver Leaf $30 copay after deductible
Silver Leaf Premier $35 copay not subject to deductible
Silver Leaf Premier Plus $30 copay not subject to deductible
Vision Exams Adult
Silver Leaf not covered
Silver Leaf Premier $35
Silver Leaf Premier Plus $30 copay after deductible
Vision Exams Pediatrics (up to Age 19)
Silver Leaf $30 copay after deductible
Silver Leaf Premier $35 copay after deductible
Silver Leaf Premier Plus $30 copay after deductible
Telemedicine (Teladoc Health®)
Silver Leaf $0 copay
Silver Leaf Premier $0 copay
Silver Leaf Premier Plus $0 copay
Specialist Visit
Silver Leaf $65 copay not subject to deductible for the first visit (PCP, specialist, outpatient mental health/substance use disorder, chiropractor, allergy, Applied Behavioral Analysis (ABA), or second-opinion visit)
$65 copay after deductible for additional visits
Silver Leaf Premier $60 copay after deductible
Silver Leaf Premier Plus $60 copay not subject to deductible for the first visit (PCP, specialist, outpatient mental health/substance use disorder, chiropractor, allergy, Applied Behavioral Analysis (ABA), or second-opinion visit)
$60 copay after deductible for additional visits
Retail Health Clinic
Silver Leaf $30 copay after deductible
Silver Leaf Premier $35 copay not subject to deductible
Silver Leaf Premier Plus $30 copay not subject to deductible
Urgent Care
Silver Leaf $70 copay after deductible
Silver Leaf Premier $70 copay after deductible
Silver Leaf Premier Plus $70 copay after deductible
Emergency Room
Silver Leaf $500 copay after deductible
Silver Leaf Premier $500 copay after deductible
Silver Leaf Premier Plus $500 copay after deductible
Ambulance
Silver Leaf $150 copay after deductible
Silver Leaf Premier $150 copay after deductible
Silver Leaf Premier Plus $150 copay after deductible
Surgeon
Silver Leaf $150 copay after deductible
Silver Leaf Premier $275 copay after deductible
Silver Leaf Premier Plus $225 copay after deductible
Outpatient Facility
Silver Leaf $150 copay after deductible
Silver Leaf Premier $275 copay after deductible
Silver Leaf Premier Plus $225 copay after deductible
Inpatient Hospital Stay
Silver Leaf $1,500 copay per admission after deductible
Silver Leaf Premier $1,500 copay per admission after deductible
Silver Leaf Premier Plus $1,500 copay per admission after deductible

Prescription drug benefits

View our comprehensive and up-to-date prescription drug list (formulary).

Silver Leaf
Silver Leaf Premier
Silver Leaf Premier Plus
Generic Drugs (Tier 1)
Silver Leaf $15 copay not subject to deductible
Silver Leaf Premier $10 copay not subject to deductible
Silver Leaf Premier Plus $15 copay not subject to deductible
Brand Name Preferred (Tier 2)
Silver Leaf $40 copay not subject to deductible
Silver Leaf Premier $55 copay not subject to deductible
Silver Leaf Premier Plus $55 copay not subject to deductible
Brand Name Non-Preferred (Tier 3)
Silver Leaf $75 copay not subject to deductible
Silver Leaf Premier 45% coinsurance after deductible
Silver Leaf Premier Plus 45% coinsurance after deductible
90-Day Mail-Order Supply for Generic (Tier 1)
Silver Leaf $37.50 copay not subject to deductible
Silver Leaf Premier $20 copay not subject to deductible
Silver Leaf Premier Plus $30 copay not subject to deductible

Additional benefits

24/7 access to telemedicine with Teladoc Health®

Talk to a doctor any time—for a $0 copay. Connect with board-certified doctors through video chat or phone for prescriptions, help diagnosing and treating non-emergency conditions, and more. Access to dermatologists is also available.

Active&Fit ExerciseRewards™ program

Physical activity is one of the simplest ways to stay healthy, and Healthfirst makes it even more rewarding! With the Active&Fit ExerciseRewards program, you can earn up to $200, and your spouse may earn up to $100, every six months if you visit a qualifying fitness center at least 50 days during the same six-month reward period.

The Active&Fit ExerciseRewards program makes working out affordable, too! For just $28/month, you get access to thousands of participating fitness centers. Premium fitness center options are available for additional monthly fees. Track your activity, monitor your progress, achieve your fitness goals, and so much more!

Plan documents

General plan information

•
  • Federal Poverty Guidelines
•
•
•

Prescription drug information

•
  • Comprehensive Formulary (List of Covered Drugs)
See all plan documents Find member forms

Frequently asked questions

Healthfirst Leaf and Leaf Premier Plans both provide quality health coverage through the NY State of Health Marketplace. The main differences are the dental and vision benefits included and the monthly premium.

  • If you want a lower monthly premium and need dental and vision coverage for children only, a Leaf Plan may be right for you.
  • If you want health coverage that includes dental and vision benefits for both children and adults, a Leaf Premier Plan may be right for you.

Both plans include the same medical coverage. The biggest difference is whether adult dental and vision coverage is included.

  • Leaf Plans
    • Comprehensive health coverage
    • Pediatric dental and vision coverage only (no adult coverage)
    • Lower monthly premium
  • Leaf Premier Plans
    • Comprehensive health coverage
    • Pediatric and adult dental and vision coverage
    • Higher monthly premium

How to choose the right plan

Once you’ve decided between a Leaf Plan and a Leaf Premier Plan, you’ll choose a Platinum, Gold, Silver, or Bronze plan based on your healthcare needs and budget. Each plan offers a different balance between your monthly premium and what you’ll pay when you get care.

  • Platinum plans: Highest monthly premiums, lowest out-of-pocket costs
  • Gold plans: Higher monthly premiums, lower out-of-pocket costs
  • Silver plans: Balanced monthly premiums and out-of-pocket costs (You may also be eligible for extra savings)
  • Bronze plans: Lower monthly premiums, higher out-of-pocket costs

You and your family can enroll in a Healthfirst Leaf or Leaf Premier Plan through the NY State of Health Marketplace. Depending on your household size and income, you may qualify for premium savings or other financial assistance.

How to enroll:

If you’re self-employed and don’t meet the income requirements for Medicaid or an Essential Plan, you can get affordable health coverage with a Healthfirst Leaf or Leaf Premier Plan. These plans offer:

  • Income-based savings (subsidies) to help lower your monthly premium, if you qualify
  • Coverage for pre-existing conditions
  • Comprehensive health coverage
  • A choice of Bronze, Silver, Gold, and Platinum plans

Yes. If you’re a freelancer, independent contractor, or gig worker, you may be eligible for coverage through the NY State of Health Marketplace. You can choose from Healthfirst Leaf and Leaf Premier Plans to find the coverage that best fits your healthcare needs and budget.

Disclaimers

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.

Coverage is provided by Healthfirst PHSP, Inc.
Plans contain exclusions and limitations.

ATENCIÓN: Dispone de servicios de asistencia lingüística y otras ayudas, gratis. Llame al 1-866-305-0408 (TTY 1-888-867-4132).

请注意:您可以免费获得语言协助服务和其他辅助服务。请致电 1-866-305-0408 (TTY 1‑888‑542‑3821)。

Telemedicine (Teladoc Health) 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). If you see an in-network primary care provider (PCP) or specialist through telehealth, either online or by phone, your normal cost-sharing amounts apply.

*Up to $400 during coverage year; up to an additional $200 during coverage year for spouse.

Last update November 1, 2026 @ 3:15 am

Bronze Leaf Plan highlights

No-cost annual checkups

Preventive and wellness visits

Hospital, emergency room, and urgent care visits

Lab tests and X-rays

Prescription drug coverage

Maternity and newborn coverage

Optional adult dental and vision coverage

24/7 access to care with telemedicine (Teladoc Health)

Physical, occupational, and speech therapy

Annual gym membership reimbursement*

Costs and plan details

Bronze Leaf
Bronze Leaf Premier
Premium
Monthly premium costs depend on household income and size
Monthly premium costs depend on household income and size
Deductible (Individual)
Bronze Leaf $5,025
Bronze Leaf Premier $4,500
Deductible (Family)
Bronze Leaf $10,050
Bronze Leaf Premier $9,000
Eligible Age
Under 65
Under 65
Eligible Service Areas
Within New York City’s five boroughs (the Bronx, Brooklyn, Manhattan, Queens, and Staten Island), Long Island, and Westchester.
Maximum Out-of-Pocket (Individual)
Bronze Leaf $12,000
Bronze Leaf Premier $12,000
Maximum Out-of-Pocket (Family)
Bronze Leaf $24,000
Bronze Leaf Premier $24,000
Your Annual Checkup
Bronze Leaf $0 copay
Bronze Leaf Premier $0 copay
Primary Care Provider (PCP) Visit
Bronze Leaf $50 copay not subject to deductible for first three visits (any combination of PCP, specialist, or outpatient mental health/substance use disorder)
$50 copay after deductible for additional visits
Bronze Leaf Premier $35 copay not subject to deductible
Dental Care Adult
Bronze Leaf Not covered
Bronze Leaf Premier $35 copay after deductible
Dental Pediatrics (up to Age 19)
Bronze Leaf $50 copay after deductible
Bronze Leaf Premier $35 copay after deductible
Vision Exams Adult
Bronze Leaf Not covered
Bronze Leaf Premier $35 copay after deductible
Vision Exams Pediatrics (up to Age 19)
Bronze Leaf $50 copay after deductible
Bronze Leaf Premier $35 copay after deductible
Telemedicine (Teladoc Health®)
Bronze Leaf $0 copay
Bronze Leaf Premier $0 copay
Specialist Visit
Bronze Leaf $75 copay not subject to deductible for first three visits (any combination of PCP, specialist, or outpatient mental health/substance use disorder)
$75 copay after deductible for additional visits
Bronze Leaf Premier $75 copay after deductible
Retail Health Clinic
Bronze Leaf $50 copay after deductible
Bronze Leaf Premier $35 copay not subject to deductible
Urgent Care
Bronze Leaf $75 copay after deductible
Bronze Leaf Premier $75 copay after deductible
Emergency Room
Bronze Leaf $500 copay after deductible
Bronze Leaf Premier $750 copay after deductible
Ambulance
Bronze Leaf $300 copay after deductible
Bronze Leaf Premier $300 copay after deductible
Surgeon
Bronze Leaf $150 copay after deductible
Bronze Leaf Premier $325 copay after deductible
Outpatient Facility
Bronze Leaf $150 copay after deductible
Bronze Leaf Premier $325 copay after deductible
Inpatient Hospital Stay
Bronze Leaf $1,500 copay per admission after deductible
Bronze Leaf Premier $2,500 copay per admission after deductible

Prescription drug benefits

View our comprehensive and up-to-date prescription drug list (formulary).

Bronze Leaf
Bronze Leaf Premier
Generic Drugs (Tier 1)
Bronze Leaf $10 copay after deductible
Bronze Leaf Premier $10 copay after deductible
Brand Name Preferred (Tier 2)
Bronze Leaf $35 copay after deductible
Bronze Leaf Premier $35 copay after deductible
Brand Name Non-Preferred (Tier 3)
Bronze Leaf $70 copay after deductible
Bronze Leaf Premier 50% coinsurance after deductible
90-Day Mail-Order Supply for Generic (Tier 1)
Bronze Leaf $25 copay after deductible
Bronze Leaf Premier $20 copay after deductible

Additional benefits

24/7 access to telemedicine with Teladoc Health®

Talk to a doctor any time—for a $0 copay. Connect with board-certified doctors through video chat or phone for prescriptions, help diagnosing and treating non-emergency conditions, and more. Access to dermatologists is also available.

Active&Fit ExerciseRewards™ program

Physical activity is one of the simplest ways to stay healthy, and Healthfirst makes it even more rewarding! With the Active&Fit ExerciseRewards program, you can earn up to $200, and your spouse may earn up to $100, every six months if you visit a qualifying fitness center at least 50 days during the same six-month reward period.

The Active&Fit ExerciseRewards program makes working out affordable, too! For just $28/month, you get access to thousands of participating fitness centers. Premium fitness center options are available for additional monthly fees. Track your activity, monitor your progress, achieve your fitness goals, and so much more!

Plan documents

General plan information

•
•

Prescription drug information

•
  • Comprehensive Drug List (Formulary)
See all plan documents Find member forms

Frequently asked questions

Healthfirst Leaf and Leaf Premier Plans both provide quality health coverage through the NY State of Health Marketplace. The main differences are the dental and vision benefits included and the monthly premium.

  • If you want a lower monthly premium and need dental and vision coverage for children only, a Leaf Plan may be right for you.
  • If you want health coverage that includes dental and vision benefits for both children and adults, a Leaf Premier Plan may be right for you.

Both plans include the same medical coverage. The biggest difference is whether adult dental and vision coverage is included.

  • Leaf Plans
    • Comprehensive health coverage
    • Pediatric dental and vision coverage only (no adult coverage)
    • Lower monthly premium
  • Leaf Premier Plans
    • Comprehensive health coverage
    • Pediatric and adult dental and vision coverage
    • Higher monthly premium

How to choose the right plan

Once you’ve decided between a Leaf Plan and a Leaf Premier Plan, you’ll choose a Platinum, Gold, Silver, or Bronze plan based on your healthcare needs and budget. Each plan offers a different balance between your monthly premium and what you’ll pay when you get care.

  • Platinum plans: Highest monthly premiums, lowest out-of-pocket costs
  • Gold plans: Higher monthly premiums, lower out-of-pocket costs
  • Silver plans: Balanced monthly premiums and out-of-pocket costs (You may also be eligible for extra savings)
  • Bronze plans: Lower monthly premiums, higher out-of-pocket costs

You and your family can enroll in a Healthfirst Leaf or Leaf Premier Plan through the NY State of Health Marketplace. Depending on your household size and income, you may qualify for premium savings or other financial assistance.

How to enroll:

If you’re self-employed and don’t meet the income requirements for Medicaid or an Essential Plan, you can get affordable health coverage with a Healthfirst Leaf or Leaf Premier Plan. These plans offer:

  • Income-based savings (subsidies) to help lower your monthly premium, if you qualify
  • Coverage for pre-existing conditions
  • Comprehensive health coverage
  • A choice of Bronze, Silver, Gold, and Platinum plans

Yes. If you’re a freelancer, independent contractor, or gig worker, you may be eligible for coverage through the NY State of Health Marketplace. You can choose from Healthfirst Leaf and Leaf Premier Plans to find the coverage that best fits your healthcare needs and budget.

Disclaimers

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.

Coverage is provided by Healthfirst PHSP, Inc.
Plans contain exclusions and limitations.

ATENCIÓN: Dispone de servicios de asistencia lingüística y otras ayudas, gratis. Llame al 1-866-305-0408 (TTY 1-888-867-4132).

请注意:您可以免费获得语言协助服务和其他辅助服务。请致电 1-866-305-0408 (TTY 1‑888‑542‑3821)。

Telemedicine (Teladoc Health) 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). If you see an in-network primary care provider (PCP) or specialist through telehealth, either online or by phone, your normal cost-sharing amounts apply.

*Up to $400 during coverage year; up to an additional $200 during coverage year for spouse.

Last update November 1, 2026 @ 3:15 am

Green Leaf Plan highlights

No-cost annual checkups

Preventive and wellness visits

Hospital, emergency room, and urgent care visits

Lab tests and X-rays

Prescription drug coverage

Maternity and newborn coverage

Optional adult dental and vision coverage

24/7 access to care with telemedicine (Teladoc Health)

Physical, occupational, and speech therapy

Annual gym membership reimbursement*

Costs and plan details

Green Leaf
Premium
Monthly premium costs depend on household income and size
Deductible (Individual)
$12,000
Deductible (Family)
$24,000
Eligible Age
Individuals under 30
Eligible Service Areas
Within New York City’s five boroughs (the Bronx, Brooklyn, Manhattan, Queens, and Staten Island), Long Island, and Westchester.
Maximum Out-of-Pocket (Individual)
$12,000
Maximum Out-of-Pocket (Family)
$24,000
Your Annual Checkup
$0 copay
Primary Care Provider (PCP) Visit
$0 copay not subject to deductible for first three visits (PCP, outpatient MH/SUD or any combination);
0% coinsurance after deductible for additional visits
Dental Pediatrics (up to Age 19)
0% coinsurance after deductible
Vision Exams Pediatrics (up to Age 19)
0% coinsurance after deductible
Telemedicine (Teladoc Health®)
$0 copay after deductible
Specialist Visit
0% coinsurance after deductible
Retail Health Clinic
0% coinsurance after deductible
Urgent Care
0% coinsurance after deductible
Emergency Room
0% coinsurance after deductible
Ambulance
0% coinsurance after deductible
Surgeon
0% coinsurance after deductible
Outpatient Facility
0% coinsurance after deductible
Inpatient Hospital Stay
0% coinsurance after deductible

Prescription drug benefits

View our comprehensive and up-to-date prescription drug list (formulary).

Green Leaf
Generic Drugs (Tier 1)
0% coinsurance after deductible
Brand Name Preferred (Tier 2)
0% coinsurance after deductible
Brand Name Non-Preferred (Tier 3)
0% coinsurance after deductible
90-Day Mail-Order Supply for Generic (Tier 1)
0% coinsurance after deductible

Additional benefits

24/7 access to telemedicine with Teladoc Health®

Talk to a doctor any time—for a $0 copay. Connect with board-certified doctors through video chat or phone for prescriptions, help diagnosing and treating non-emergency conditions, and more. Access to dermatologists is also available.

Active&Fit ExerciseRewards™ program

Physical activity is one of the simplest ways to stay healthy, and Healthfirst makes it even more rewarding! With the Active&Fit ExerciseRewards program, you can earn up to $200, and your spouse may earn up to $100, every six months if you visit a qualifying fitness center at least 50 days during the same six-month reward period.

The Active&Fit ExerciseRewards program makes working out affordable, too! For just $28/month, you get access to thousands of participating fitness centers. Premium fitness center options are available for additional monthly fees. Track your activity, monitor your progress, achieve your fitness goals, and so much more!

Plan documents

General plan information

•

Prescription drug information

•
  • Comprehensive Drug List (Formulary)
See all plan documents Find member forms

Frequently asked questions

Healthfirst Leaf and Leaf Premier Plans both provide quality health coverage through the NY State of Health Marketplace. The main differences are the dental and vision benefits included and the monthly premium.

  • If you want a lower monthly premium and need dental and vision coverage for children only, a Leaf Plan may be right for you.
  • If you want health coverage that includes dental and vision benefits for both children and adults, a Leaf Premier Plan may be right for you.

Both plans include the same medical coverage. The biggest difference is whether adult dental and vision coverage is included.

  • Leaf Plans
    • Comprehensive health coverage
    • Pediatric dental and vision coverage only (no adult coverage)
    • Lower monthly premium
  • Leaf Premier Plans
    • Comprehensive health coverage
    • Pediatric and adult dental and vision coverage
    • Higher monthly premium

How to choose the right plan

Once you’ve decided between a Leaf Plan and a Leaf Premier Plan, you’ll choose a Platinum, Gold, Silver, or Bronze plan based on your healthcare needs and budget. Each plan offers a different balance between your monthly premium and what you’ll pay when you get care.

  • Platinum plans: Highest monthly premiums, lowest out-of-pocket costs
  • Gold plans: Higher monthly premiums, lower out-of-pocket costs
  • Silver plans: Balanced monthly premiums and out-of-pocket costs (You may also be eligible for extra savings)
  • Bronze plans: Lower monthly premiums, higher out-of-pocket costs

You and your family can enroll in a Healthfirst Leaf or Leaf Premier Plan through the NY State of Health Marketplace. Depending on your household size and income, you may qualify for premium savings or other financial assistance.

How to enroll:

If you’re self-employed and don’t meet the income requirements for Medicaid or an Essential Plan, you can get affordable health coverage with a Healthfirst Leaf or Leaf Premier Plan. These plans offer:

  • Income-based savings (subsidies) to help lower your monthly premium, if you qualify
  • Coverage for pre-existing conditions
  • Comprehensive health coverage
  • A choice of Bronze, Silver, Gold, and Platinum plans

Yes. If you’re a freelancer, independent contractor, or gig worker, you may be eligible for coverage through the NY State of Health Marketplace. You can choose from Healthfirst Leaf and Leaf Premier Plans to find the coverage that best fits your healthcare needs and budget.

Disclaimers

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.

Coverage is provided by Healthfirst PHSP, Inc.
Plans contain exclusions and limitations.

ATENCIÓN: Dispone de servicios de asistencia lingüística y otras ayudas, gratis. Llame al 1-866-305-0408 (TTY 1-888-867-4132).

请注意:您可以免费获得语言协助服务和其他辅助服务。请致电 1-866-305-0408 (TTY 1‑888‑542‑3821)。

Telemedicine (Teladoc Health) 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). If you see an in-network primary care provider (PCP) or specialist through telehealth, either online or by phone, your normal cost-sharing amounts apply.

*Up to $400 during coverage year; up to an additional $200 during coverage year for spouse.

Last update November 1, 2026 @ 3:15 am

CHOOSE PLAN LEVEL

Platinum Leaf Plan highlights

No-cost annual checkups

Preventive and wellness visits

Hospital, emergency room, and urgent care visits

Lab tests and x-rays

Prescription drug coverage

Maternity and newborn coverage

Optional dental and vision coverage

24/7 access to care with telemedicine (Teladoc)

Physical, occupational, and speech therapy

Annual gym membership reimbursement*

Costs and plan details

Platinum Leaf
Platinum Leaf Premier
Premium
Monthly premium costs depend on household income and size
Monthly premium costs depend on household income and size
Deductible (Individual)
Platinum Leaf $0
Platinum Leaf Premier $0
Deductible (Family)
Platinum Leaf $0
Platinum Leaf Premier $0
Eligible Age
Under 65
Under 65
Eligible Service Areas
Within New York City’s five boroughs (the Bronx, Brooklyn, Manhattan, Queens, and Staten Island), Long Island, and Westchester.
Maximum Out-of-Pocket (Individual)
Platinum Leaf $2,000
Platinum Leaf Premier $2,000
Maximum Out-of-Pocket (Family)
Platinum Leaf $4,000
Platinum Leaf Premier $4,000
Your Annual Checkup
Platinum Leaf $0 copay
Platinum Leaf Premier $0 copay
Primary Care Provider (PCP) Visit
Platinum Leaf $15 copay
Platinum Leaf Premier $10 copay
Dental Care Adult
Platinum Leaf Not covered
Platinum Leaf Premier $10 copay
Dental Pediatrics (up to Age 19)
Platinum Leaf $15 copay
Platinum Leaf Premier $10 copay
Vision Exams Adult
Platinum Leaf Not covered
Platinum Leaf Premier $10 copay
Vision Exams Pediatrics (up to Age 19)
Platinum Leaf $15 copay
Platinum Leaf Premier $10 copay
Telemedicine (Teladoc)
Platinum Leaf $0 copay
Platinum Leaf Premier $0 copay
Specialist Visit
Platinum Leaf $35 copay
Platinum Leaf Premier $35 copay
Retail Health Clinic
Platinum Leaf $15 copay
Platinum Leaf Premier $10 copay
Urgent Care
Platinum Leaf $55 copay
Platinum Leaf Premier $55 copay
Emergency Room
Platinum Leaf $100 copay
Platinum Leaf Premier $100 copay
Ambulance
Platinum Leaf $100 copay
Platinum Leaf Premier $100 copay
Surgeon
Platinum Leaf $100 copay
Platinum Leaf Premier $100 copay
Outpatient Facility
Platinum Leaf $100 copay
Platinum Leaf Premier $100 copay
Inpatient Hospital Stay
Platinum Leaf $500 copay per admission
Platinum Leaf Premier $500 copay per admission

Prescription drug benefits

Platinum Leaf
Platinum Leaf Premier
Generic Drugs (Tier 1)
Platinum Leaf $10 copay
Platinum Leaf Premier $5 copay
Brand Name Preferred (Tier 2)
Platinum Leaf $30 copay
Platinum Leaf Premier $50 copay
Brand Name Non-Preferred (Tier 3)
Platinum Leaf $60 copay
Platinum Leaf Premier $85 copay
90-Day Mail-Order Supply for Generic (Tier 1)
Platinum Leaf $25 copay
Platinum Leaf Premier $10 copay

Additional benefits

24/7 access to telemedicine with Teladoc

Talk to a doctor any time—for a $0 copay. Connect with board-certified doctors through video chat or phone for prescriptions, help diagnosing and treating non-emergency conditions, and more. Access to dermatologists is also available.

Active&Fit ExerciseRewards™ program

Physical activity is one of the simplest ways to stay healthy, and Healthfirst makes it even more rewarding! With the Active&Fit ExerciseRewards program, you can earn up to $200 every six months if you visit a qualifying fitness center at least 50 days during the same six-month reward period.

The Active&Fit ExerciseRewards program makes working out affordable, too! For just $28/month, you get access to thousands of participating fitness centers. Premium fitness center options are available for additional monthly fees. Track your activity, monitor your progress, achieve your fitness goals, and so much more!

Plan documents

General plan information

•
•

Prescription drug information

•
  • Comprehensive Formulary (List of Covered Drugs)
See all plan documents Find member forms

Frequently asked questions

Also known as Qualified Health Plans (QHP), NY Marketplace insurance plans:

  • Are certified by the Health Insurance Marketplace
  • Provide essential health benefits
  • Follow established limits on cost sharing (e.g., deductibles, copays, and out-of-pocket maximums)
  • Meet the Affordable Care Act requirement for having health coverage, known as “minimum essential coverage”

You may qualify for a Marketplace insurance plan if you are:

  • A New York State resident
  • Lawfully present in the U.S.
  • Not eligible for Medicaid, an Essential Plan, or Child Health Plus

Yes! You can apply to lower the cost of your health insurance and see if you qualify for free or low-cost coverage from Medicaid, the Essential Plan, or Child Health Plus. Here’s how:

Disclaimers

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.

Coverage is provided by Healthfirst PHSP, Inc.
Plans contain exclusions and limitations.

ATENCIÓN: Dispone de servicios de asistencia lingüística y otras ayudas, gratis. Llame al 1-866-305-0408 (TTY 1-888-867-4132).

请注意:您可以免费获得语言协助服务和其他辅助服务。请致电 1-866-305-0408 (TTY 1‑888‑542‑3821)。

Telemedicine (Teladoc Health) 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). If you see an in-network primary care provider (PCP) or specialist through telehealth, either online or by phone, your normal cost-sharing amounts apply.

*Up to $400 during coverage year; up to an additional $200 during coverage year for spouse.

Last update November 1, 2026 @ 3:15 am

Gold Leaf Plan highlights

No-cost annual checkups

Preventive and wellness visits

Hospital, emergency room, and urgent care visits

Lab tests and x-rays

Prescription drug coverage

Maternity and newborn coverage

Optional dental and vision coverage

24/7 access to care with telemedicine (Teladoc)

Physical, occupational, and speech therapy

Annual gym membership reimbursement*

Costs and plan details

Gold Leaf
Gold Leaf Premier
Gold Leaf Premier Plus
Premium
Monthly premium costs depend on household income and size
Deductible (Individual)
Gold Leaf $775
Gold Leaf Premier $1,175
Gold Leaf Premier Plus $950
Deductible (Family)
Gold Leaf $1,550
Gold Leaf Premier $2,350
Gold Leaf Premier Plus $1,900
Eligible Age
Under 65
Under 65
Under 65
Eligible Service Areas
Within New York City’s five boroughs (the Bronx, Brooklyn, Manhattan, Queens, and Staten Island), Long Island and Westchester.
Maximum Out-of-Pocket (Individual)
Gold Leaf $10,150
Gold Leaf Premier $7,400
Gold Leaf Premier Plus $6,600
Maximum Out-of-Pocket (Family)
Gold Leaf $20,300
Gold Leaf Premier $14,800
Gold Leaf Premier Plus $13,200
Your Annual Checkup
Gold Leaf $0 copay
Gold Leaf Premier $0 copay
Gold Leaf Premier Plus $0 copay
Primary Care Provider (PCP) Visit
Gold Leaf $25 copay after deductible
Gold Leaf Premier $25 copay not subject to deductible
Gold Leaf Premier Plus $30 copay not subject to deductible for first visit (PCP, specialist, outpatient mental health/substance use disorder, chiropractor, allergy, Applied Behavioral Analysis (ABA), or second-opinion visit)
$30 copay after deductible for additional visits
Dental Care Adult
Gold Leaf Not covered
Gold Leaf Premier $25 copay not subject to deductible
Gold Leaf Premier Plus $30 copay not subject to deductible
Dental Pediatrics (up to Age 19)
Gold Leaf $25 copay after deductible
Gold Leaf Premier $25 copay not subject to deductible
Gold Leaf Premier Plus $30 copay not subject to deductible
Vision Exams Adult
Gold Leaf Not covered
Gold Leaf Premier $25 copay after deductible
Gold Leaf Premier Plus $30 copay after deductible
Vision Exams Pediatrics (up to Age 19)
Gold Leaf $25 copay after deductible
Gold Leaf Premier $25 copay after deductible
Gold Leaf Premier Plus $30 copay after deductible
Telemedicine (Teladoc)
Gold Leaf $0 copay
Gold Leaf Premier $0 copay
Gold Leaf Premier Plus $0 copay
Specialist Visit
Gold Leaf $40 copay after deductible
Gold Leaf Premier $45 copay after deductible
Gold Leaf Premier Plus $45 copay not subject to deductible for first visit (PCP, specialist, outpatient mental health/substance use disorder, chiropractor, allergy, Applied Behavioral Analysis (ABA), or second-opinion visit)
$40 copay after deductible for additional visits
Retail Health Clinic
Gold Leaf $25 copay after deductible
Gold Leaf Premier $25 copay not subject to deductible
Gold Leaf Premier Plus $25 copay not subject to deductible
Urgent Care
Gold Leaf $60 copay after deductible
Gold Leaf Premier $60 copay after deductible
Gold Leaf Premier Plus $60 copay after deductible
Emergency Room
Gold Leaf $150 copay after deductible
Gold Leaf Premier $175 copay after deductible
Gold Leaf Premier Plus $250 copay after deductible
Ambulance
Gold Leaf $150 copay after deductible
Gold Leaf Premier $150 copay after deductible
Gold Leaf Premier Plus $150 copay after deductible
Surgeon
Gold Leaf $100 copay after deductible
Gold Leaf Premier $100 copay after deductible
Gold Leaf Premier Plus $100 copay after deductible
Outpatient Facility
Gold Leaf $100 copay after deductible
Gold Leaf Premier $100 copay after deductible
Gold Leaf Premier Plus $100 copay after deductible
Inpatient Hospital Stay
Gold Leaf $1,000 copay after deductible per admission
Gold Leaf Premier $1,000 copay after deductible per admission
Gold Leaf Premier Plus $1,000 copay after deductible per admission

Prescription drug benefits

Gold Leaf
Gold Leaf Premier
Gold Leaf Premier Plus
Generic Drugs (Tier 1)
Gold Leaf $10 copay
Gold Leaf Premier $7 copay
Gold Leaf Premier Plus $10 copay
Brand Name Preferred (Tier 2)
Gold Leaf $35 copay
Gold Leaf Premier $50 copay
Gold Leaf Premier Plus $50 copay
Brand Name Non-Preferred (Tier 3)
Gold Leaf $70 copay
Gold Leaf Premier $100 copay
Gold Leaf Premier Plus $100 copay
90-Day Mail-Order Supply for Generic (Tier 1)
Gold Leaf $25 copay
Gold Leaf Premier $14 copay
Gold Leaf Premier Plus $20 copay

Additional benefits

24/7 access to telemedicine with Teladoc

Talk to a doctor any time—for a $0 copay. Connect with board-certified doctors through video chat or phone for prescriptions, help diagnosing and treating non-emergency conditions, and more. Access to dermatologists is also available.

Active&Fit ExerciseRewards™ program

Physical activity is one of the simplest ways to stay healthy, and Healthfirst makes it even more rewarding! With the Active&Fit ExerciseRewards program, you can earn up to $200 every six months if you visit a qualifying fitness center at least 50 days during the same six-month reward period.

The Active&Fit ExerciseRewards program makes working out affordable, too! For just $28/month, you get access to thousands of participating fitness centers. Premium fitness center options are available for additional monthly fees. Track your activity, monitor your progress, achieve your fitness goals, and so much more!

Plan documents

General plan information

•
•
•

Prescription drug information

•
  • Comprehensive Formulary (List of Covered Drugs)
See all plan documents Find member forms

Frequently asked questions

Also known as Qualified Health Plans (QHP), NY Marketplace insurance plans:

  • Are certified by the Health Insurance Marketplace
  • Provide essential health benefits
  • Follow established limits on cost sharing (e.g., deductibles, copays, and out-of-pocket maximums)
  • Meet the Affordable Care Act requirement for having health coverage, known as “minimum essential coverage”

You may qualify for a Marketplace insurance plan if you are:

  • A New York State resident
  • Lawfully present in the U.S.
  • Not eligible for Medicaid, an Essential Plan, or Child Health Plus

Yes! You can apply to lower the cost of your health insurance and see if you qualify for free or low-cost coverage from Medicaid, the Essential Plan, or Child Health Plus. Here’s how:

Disclaimers

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.

Coverage is provided by Healthfirst PHSP, Inc.
Plans contain exclusions and limitations.

ATENCIÓN: Dispone de servicios de asistencia lingüística y otras ayudas, gratis. Llame al 1-866-305-0408 (TTY 1-888-867-4132).

请注意:您可以免费获得语言协助服务和其他辅助服务。请致电 1-866-305-0408 (TTY 1‑888‑542‑3821)。

Telemedicine (Teladoc Health) 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). If you see an in-network primary care provider (PCP) or specialist through telehealth, either online or by phone, your normal cost-sharing amounts apply.

*Up to $400 during coverage year; up to an additional $200 during coverage year for spouse.

Last update November 1, 2026 @ 3:15 am

2026 plan highlights

No-cost annual checkups

Preventive and wellness visits

Hospital, emergency room, and urgent care visits

Lab tests and x-rays

Prescription drug coverage

Maternity and newborn coverage

Optional dental and vision coverage

24/7 access to care with telemedicine (Teladoc)

Physical, occupational, and speech therapy

Annual gym membership reimbursement*

Costs and plan details

Silver Leaf
Silver Leaf Premier
Silver Leaf Premier Plus
Premium
Monthly premium costs depend on household income and size
Eligible Age
Under 65
Eligible Service Areas
Within New York City’s five boroughs (the Bronx, Brooklyn, Manhattan, Queens, and Staten Island), Long Island, and Westchester.
Deductible (individual)
Maximum Out-of-Pocket (individual)
Deductible (Family)
Maximum Out-of-Pocket (Family)
Your Annual Checkup
Primary Care Provider (PCP) Visit
Dental Care Adult
Dental Pediatrics (up to Age 19)
Vision Exams Adult
Vision Exams Pediatrics (up to Age 19)
Telemedicine (Teladoc)
Specialist Visit
Retail Health Clinic
Urgent Care
Emergency Room
Ambulance
Surgeon
Outpatient Facility
Inpatient Hospital Stay

Prescription drug benefits

Silver Leaf
Silver Leaf Premier
Silver Leaf Premier Plus
Generic Drugs (Tier 1)
Brand Name Preferred (Tier 2)
Brand Name Non-Preferred (Tier 3)
90-Day Mail-Order Supply for Generic (Tier 1)

Additional benefits

24/7 access to telemedicine with Teladoc

Talk to a doctor any time—for a $0 copay. Connect with board-certified doctors through video chat or phone for prescriptions, help diagnosing and treating non-emergency conditions, and more. Access to dermatologists is also available.

Active&Fit ExerciseRewards™ program

Physical activity is one of the simplest ways to stay healthy, and Healthfirst makes it even more rewarding! With the Active&Fit ExerciseRewards program, you can earn up to $200 every six months if you visit a qualifying fitness center at least 50 days during the same six-month reward period.

The Active&Fit ExerciseRewards program makes working out affordable, too! For just $28/month, you get access to thousands of participating fitness centers. Premium fitness center options are available for additional monthly fees. Track your activity, monitor your progress, achieve your fitness goals, and so much more!

Plan documents

General plan information

•
  • Federal Poverty Guidelines
•
  • Summary of Benefits and Coverage - Silver Leaf Premier Plus (>400% FPL)
•
  • Summary of Benefits and Coverage - Silver Leaf Premier Plus (350 - 400% FPL)
•
  • Summary of Benefits and Coverage - Silver Leaf Premier Plus (150 - 350% FPL)
•
  • Summary of Benefits and Coverage - Silver Leaf Premier Plus (100 - 150% FPL)
•
•
  • Summary of Benefits and Coverage - Silver Leaf Premier (350 - 400% FPL)
•
  • Summary of Benefits and Coverage - Silver Leaf Premier (150 - 350% FPL)
•
  • Summary of Benefits and Coverage - Silver Leaf Premier (100 - 150% FPL)
•
•
•
•

Prescription drug information

•
  • Comprehensive Formulary (List of Covered Drugs)

Disclaimers

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.

Coverage is provided by Healthfirst PHSP, Inc.
Plans contain exclusions and limitations.

ATENCIÓN: Dispone de servicios de asistencia lingüística y otras ayudas, gratis. Llame al 1-866-305-0408 (TTY 1-888-867-4132).

请注意:您可以免费获得语言协助服务和其他辅助服务。请致电 1-866-305-0408 (TTY 1‑888‑542‑3821)。

Telemedicine (Teladoc Health) 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). If you see an in-network primary care provider (PCP) or specialist through telehealth, either online or by phone, your normal cost-sharing amounts apply.

*Up to $400 during coverage year; up to an additional $200 during coverage year for spouse.

Last update November 1, 2026 @ 3:15 am

Silver Leaf Plan Highlights

No-cost annual checkups

Preventive and wellness visits

Hospital, emergency room, and urgent care visits

Lab tests and x-rays

Prescription drug coverage

Maternity and newborn coverage

Optional dental and vision coverage

24/7 access to care with telemedicine (Teladoc)

Physical, occupational, and speech therapy

Annual gym membership reimbursement*

Costs and plan details

Silver Leaf
Silver Leaf Premier
Silver Leaf Premier Plus
Premium
Monthly premium costs depend on household income and size
Deductible (Individual)
Silver Leaf $0
Silver Leaf Premier $0
Silver Leaf Premier Plus $0
Deductible (Family)
Silver Leaf $0
Silver Leaf Premier $0
Silver Leaf Premier Plus $0
Eligible Age
Under 65
Under 65
Under 65
Eligible Service Areas
Within New York City’s five boroughs (the Bronx, Brooklyn, Manhattan, Queens, and Staten Island), Long Island, and Westchester.
Maximum Out-of-Pocket (Individual)
Silver Leaf $1,275
Silver Leaf Premier $1,350
Silver Leaf Premier Plus $1,150
Maximum Out-of-Pocket (Family)
Silver Leaf $2,550
Silver Leaf Premier $2,700
Silver Leaf Premier Plus $2,300
Your Annual Checkup
Silver Leaf $0 copay
Silver Leaf Premier $0 copay
Silver Leaf Premier Plus $0 copay
Primary Care Provider (PCP) Visit
Silver Leaf $10 copay
Silver Leaf Premier $10 copay
Silver Leaf Premier Plus $10 copay
Dental Care Adult
Silver Leaf not covered
Silver Leaf Premier $10 copay
Silver Leaf Premier Plus $10 copay
Dental Pediatrics (up to Age 19)
Silver Leaf $10 copay
Silver Leaf Premier $10 copay
Silver Leaf Premier Plus $10 copay
Vision Exams Adult
Silver Leaf not covered
Silver Leaf Premier $10 copay
Silver Leaf Premier Plus $10 copay
Vision Exams Pediatrics (up to Age 19)
Silver Leaf $10 copay
Silver Leaf Premier $10 copay
Silver Leaf Premier Plus $10 copay
Telemedicine (Teladoc)
Silver Leaf $0 copay
Silver Leaf Premier $0 copay
Silver Leaf Premier Plus $0 copay
Specialist Visit
Silver Leaf $20 copay
Silver Leaf Premier $20 copay
Silver Leaf Premier Plus $20 copay
Retail Health Clinic
Silver Leaf $10 copay
Silver Leaf Premier $10 copay
Silver Leaf Premier Plus $10 copay
Urgent Care
Silver Leaf $30 copay
Silver Leaf Premier $30 copay
Silver Leaf Premier Plus $30 copay
Emergency Room
Silver Leaf $50 copay
Silver Leaf Premier $50 copay
Silver Leaf Premier Plus $50 copay
Ambulance
Silver Leaf $50 copay
Silver Leaf Premier $150 copay
Silver Leaf Premier Plus $150 copay
Surgeon
Silver Leaf $25 copay
Silver Leaf Premier $25 copay
Silver Leaf Premier Plus $25 copay
Outpatient Facility
Silver Leaf $25 copay
Silver Leaf Premier $25 copay
Silver Leaf Premier Plus $25 copay
Inpatient Hospital Stay
Silver Leaf $100 copay per admission
Silver Leaf Premier $100 copay per admission
Silver Leaf Premier Plus $100 copay per admission

Prescription drug benefits

Silver Leaf
Silver Leaf Premier
Silver Leaf Premier Plus
Generic Drugs (Tier 1)
Silver Leaf $6 copay
Silver Leaf Premier $6 copay
Silver Leaf Premier Plus $10 copay
Brand Name Preferred (Tier 2)
Silver Leaf $15 copay
Silver Leaf Premier $40 copay
Silver Leaf Premier Plus $55 copay
Brand Name Non-Preferred (Tier 3)
Silver Leaf $30 copay
Silver Leaf Premier $100 copay
Silver Leaf Premier Plus $100 copay
90-Day Mail-Order Supply for Generic (Tier 1)
Silver Leaf $15 copay
Silver Leaf Premier $12 copay
Silver Leaf Premier Plus $20 copay

Additional benefits

24/7 access to telemedicine with Teladoc

Talk to a doctor any time—for a $0 copay. Connect with board-certified doctors through video chat or phone for prescriptions, help diagnosing and treating non-emergency conditions, and more. Access to dermatologists is also available.

Active&Fit ExerciseRewards™ program

Physical activity is one of the simplest ways to stay healthy, and Healthfirst makes it even more rewarding! With the Active&Fit ExerciseRewards program, you can earn up to $200 every six months if you visit a qualifying fitness center at least 50 days during the same six-month reward period.

The Active&Fit ExerciseRewards program makes working out affordable, too! For just $28/month, you get access to thousands of participating fitness centers. Premium fitness center options are available for additional monthly fees. Track your activity, monitor your progress, achieve your fitness goals, and so much more!

Plan documents

General plan information

•
  • Federal Poverty Guidelines
•
  • Summary of Benefits and Coverage - Silver Leaf Premier Plus (100 - 150% FPL)
•
  • Summary of Benefits and Coverage - Silver Leaf Premier (100 - 150% FPL)
•

Prescription drug information

•
  • Comprehensive Formulary (List of Covered Drugs)
See all plan documents Find member forms

Frequently asked questions

Also known as Qualified Health Plans (QHP), NY Marketplace insurance plans:

  • Are certified by the Health Insurance Marketplace
  • Provide essential health benefits
  • Follow established limits on cost sharing (e.g., deductibles, copays, and out-of-pocket maximums)
  • Meet the Affordable Care Act requirement for having health coverage, known as “minimum essential coverage”

You may qualify for a Marketplace insurance plan if you are:

  • A New York State resident
  • Lawfully present in the U.S.
  • Not eligible for Medicaid, an Essential Plan, or Child Health Plus

Yes! You can apply to lower the cost of your health insurance and see if you qualify for free or low-cost coverage from Medicaid, the Essential Plan, or Child Health Plus. Here’s how:

Disclaimers

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.

Coverage is provided by Healthfirst PHSP, Inc.
Plans contain exclusions and limitations.

ATENCIÓN: Dispone de servicios de asistencia lingüística y otras ayudas, gratis. Llame al 1-866-305-0408 (TTY 1-888-867-4132).

请注意:您可以免费获得语言协助服务和其他辅助服务。请致电 1-866-305-0408 (TTY 1‑888‑542‑3821)。

Telemedicine (Teladoc Health) 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). If you see an in-network primary care provider (PCP) or specialist through telehealth, either online or by phone, your normal cost-sharing amounts apply.

*Up to $400 during coverage year; up to an additional $200 during coverage year for spouse.

Last update November 1, 2026 @ 3:15 am

Silver Leaf Plan highlights

No-cost annual checkups

Preventive and wellness visits

Hospital, emergency room, and urgent care visits

Lab tests and x-rays

Prescription drug coverage

Maternity and newborn coverage

Optional dental and vision coverage

24/7 access to care with telemedicine (Teladoc)

Physical, occupational, and speech therapy

Annual gym membership reimbursement*

Costs and plan details

Silver Leaf
Silver Leaf Premier
Silver Leaf Premier Plus
Premium
Monthly premium costs depend on household income and size
Deductible (Individual)
Silver Leaf $450
Silver Leaf Premier $250
Silver Leaf Premier Plus $250
Deductible (Family)
Silver Leaf $900
Silver Leaf Premier $500
Silver Leaf Premier Plus $500
Eligible Age
Under 65
Under 65
Under 65
Eligible Service Areas
Within New York City’s five boroughs (the Bronx, Brooklyn, Manhattan, Queens, and Staten Island), Long Island, and Westchester.
Maximum Out-of-Pocket (Individual)
Silver Leaf $3,350
Silver Leaf Premier $2,500
Silver Leaf Premier Plus $2,300
Maximum Out-of-Pocket (Family)
Silver Leaf $6,700
Silver Leaf Premier $5,000
Silver Leaf Premier Plus $4,600
Your Annual Checkup
Silver Leaf $0 copay
Silver Leaf Premier $0 copay
Silver Leaf Premier Plus $0 copay
Primary Care Provider (PCP) Visit
Silver Leaf $15 copay not subject to deductible for first visit (PCP, specialist, outpatient mental health/substance use disorder, chiropractor, allergy, Applied Behavioral Analysis (ABA), or second-opinion visit)
$15 copay after deductible for additional visits
Silver Leaf Premier $30 copay not subject to deductible
Silver Leaf Premier Plus $30 copay not subject to deductible for first visit (PCP, specialist, outpatient mental health/substance use disorder, chiropractor, allergy, Applied Behavioral Analysis (ABA), or second-opinion visit)
$30 copay after deductible for additional visits
Dental Care Adult
Silver Leaf not covered
Silver Leaf Premier $30 copay not subject to deductible
Silver Leaf Premier Plus $30 copay not subject to deductible
Dental Pediatrics (up to Age 19)
Silver Leaf $15 copay after deductible
Silver Leaf Premier $30 copay not subject to deductible
Silver Leaf Premier Plus $30 copay not subject to deductible
Vision Exams Adult
Silver Leaf not covered
Silver Leaf Premier $30 copay after deductible
Silver Leaf Premier Plus $30 copay after deductible
Vision Exams Pediatrics (up to Age 19)
Silver Leaf $15 copay after deductible
Silver Leaf Premier $30 copay after deductible
Silver Leaf Premier Plus $30 copay after deductible
Telemedicine (Teladoc)
Silver Leaf $0 copay
Silver Leaf Premier $0 copay
Silver Leaf Premier Plus $0 copay
Specialist Visit
Silver Leaf $35 copay not subject to deductible for first visit (PCP, specialist, outpatient mental health/substance use disorder, chiropractor, allergy, Applied Behavioral Analysis (ABA), or second-opinion visit)
$35 copay after deductible for additional visits
Silver Leaf Premier $55 copay after deductible
Silver Leaf Premier Plus $65 copay not subject to deductible for first visit (PCP, specialist, outpatient mental health/substance use disorder, chiropractor, allergy, Applied Behavioral Analysis (ABA), or second-opinion visit)
$65 copay after deductible for additional visits
Retail Health Clinic
Silver Leaf $15 copay after deductible
Silver Leaf Premier $30 copay not subject to deductible
Silver Leaf Premier Plus $30 copay not subject to deductible
Urgent Care
Silver Leaf $50 copay after deductible
Silver Leaf Premier $70 copay after deductible
Silver Leaf Premier Plus $70 copay after deductible
Emergency Room
Silver Leaf $75 copay after deductible
Silver Leaf Premier $250 copay after deductible
Silver Leaf Premier Plus $500 copay after deductible
Ambulance
Silver Leaf $75 copay after deductible
Silver Leaf Premier $150 copay after deductible
Silver Leaf Premier Plus $150 copay after deductible
Surgeon
Silver Leaf $75 copay after deductible
Silver Leaf Premier $100 copay after deductible
Silver Leaf Premier Plus $100 copay after deductible
Outpatient Facility
Silver Leaf $75 copay after deductible
Silver Leaf Premier $100 copay after deductible
Silver Leaf Premier Plus $100 copay after deductible
Inpatient Hospital Stay
Silver Leaf $250 copay per admission after deductible
Silver Leaf Premier $1,500 copay per admission after deductible
Silver Leaf Premier Plus $1,500 copay per admission after deductible

Prescription drug benefits

Silver Leaf
Silver Leaf Premier
Silver Leaf Premier Plus
Generic Drugs (Tier 1)
Silver Leaf $9 copay not subject to deductible
Silver Leaf Premier $10 copay not subject to deductible
Silver Leaf Premier Plus $15 copay not subject to deductible
Brand Name Preferred (Tier 2)
Silver Leaf $20 copay not subject to deductible
Silver Leaf Premier $55 copay not subject to deductible
Silver Leaf Premier Plus $55 copay not subject to deductible
Brand Name Non-Preferred (Tier 3)
Silver Leaf $40 copay not subject to deductible
Silver Leaf Premier $100 copay not subject to deductible
Silver Leaf Premier Plus $100 copay not subject to deductible
90-Day Mail-Order Supply for Generic (Tier 1)
Silver Leaf $22.50 copay
Silver Leaf Premier $20 copay
Silver Leaf Premier Plus $30 copay

Additional benefits

24/7 access to telemedicine with Teladoc

Talk to a doctor any time—for a $0 copay. Connect with board-certified doctors through video chat or phone for prescriptions, help diagnosing and treating non-emergency conditions, and more. Access to dermatologists is also available.

Active&Fit ExerciseRewards™ program

Physical activity is one of the simplest ways to stay healthy, and Healthfirst makes it even more rewarding! With the Active&Fit ExerciseRewards program, you can earn up to $200 every six months if you visit a qualifying fitness center at least 50 days during the same six-month reward period.

The Active&Fit ExerciseRewards program makes working out affordable, too! For just $28/month, you get access to thousands of participating fitness centers. Premium fitness center options are available for additional monthly fees. Track your activity, monitor your progress, achieve your fitness goals, and so much more!

Plan documents

General plan information

•
  • Federal Poverty Guidelines
•
  • Summary of Benefits and Coverage - Silver Leaf Premier Plus (150 -350% FPL)
•
  • Summary of Benefits and Coverage - Silver Leaf Premier (150 - 350% FPL)
•

Prescription drug information

•
  • Comprehensive Formulary (List of Covered Drugs)
Find member forms

Frequently asked questions

Also known as Qualified Health Plans (QHP), NY Marketplace insurance plans:

  • Are certified by the Health Insurance Marketplace
  • Provide essential health benefits
  • Follow established limits on cost sharing (e.g., deductibles, copays, and out-of-pocket maximums)
  • Meet the Affordable Care Act requirement for having health coverage, known as “minimum essential coverage”

You may qualify for a Marketplace insurance plan if you are:

  • A New York State resident
  • Lawfully present in the U.S.
  • Not eligible for Medicaid, an Essential Plan, or Child Health Plus

Yes! You can apply to lower the cost of your health insurance and see if you qualify for free or low-cost coverage from Medicaid, the Essential Plan, or Child Health Plus. Here’s how:

Disclaimers

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.

Coverage is provided by Healthfirst PHSP, Inc.
Plans contain exclusions and limitations.

ATENCIÓN: Dispone de servicios de asistencia lingüística y otras ayudas, gratis. Llame al 1-866-305-0408 (TTY 1-888-867-4132).

请注意:您可以免费获得语言协助服务和其他辅助服务。请致电 1-866-305-0408 (TTY 1‑888‑542‑3821)。

Telemedicine (Teladoc Health) 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). If you see an in-network primary care provider (PCP) or specialist through telehealth, either online or by phone, your normal cost-sharing amounts apply.

*Up to $400 during coverage year; up to an additional $200 during coverage year for spouse.

Last update November 1, 2026 @ 3:15 am

Silver Leaf Plan highlights

No-cost annual checkups

Preventive and wellness visits

Hospital, emergency room, and urgent care visits

Lab tests and x-rays

Prescription drug coverage

Maternity and newborn coverage

Optional dental and vision coverage

24/7 access to care with telemedicine (Teladoc)

Physical, occupational, and speech therapy

Annual gym membership reimbursement*

Costs and plan details

Silver Leaf
Silver Leaf Premier
Silver Leaf Premier Plus
Premium
Monthly premium costs depend on household income and size
Deductible (Individual)
Silver Leaf $2,160
Silver Leaf Premier $4,000
Silver Leaf Premier Plus $2,050
Deductible (Family)
Silver Leaf $4,320
Silver Leaf Premier $8,000
Silver Leaf Premier Plus $4,100
Eligible Age
Under 65
Under 65
Under 65
Eligible Service Areas
Within New York City’s five boroughs (the Bronx, Brooklyn, Manhattan, Queens, and Staten Island), Long Island, and Westchester.
Maximum Out-of-Pocket (Individual)
Silver Leaf $8,100
Silver Leaf Premier $7,900
Silver Leaf Premier Plus $7,650
Maximum Out-of-Pocket (Family)
Silver Leaf $16,200
Silver Leaf Premier $15,800
Silver Leaf Premier Plus $15,300
Your Annual Checkup
Silver Leaf $0 copay
Silver Leaf Premier $0 copay
Silver Leaf Premier Plus $0 copay
Primary Care Provider (PCP) Visit
Silver Leaf $30 copay not subject to deductible for the first visit (PCP, specialist, outpatient mental health/substance use disorder, chiropractor, allergy, Applied Behavioral Analysis (ABA), or second-opinion visit)
$30 copay after deductible for additional visits
Silver Leaf Premier $35 copay not subject to deductible
Silver Leaf Premier Plus $35 copay not subject to deductible for the first visit (PCP, specialist, outpatient mental health/substance use disorder, chiropractor, allergy, Applied Behavioral Analysis (ABA), or second-opinion visit)
$30 copay after deductible for additional visits
Dental Care Adult
Silver Leaf not covered
Silver Leaf Premier $35 copay not subject to deductible
Silver Leaf Premier Plus $35 copay not subject to deductible
Dental Pediatrics (up to Age 19)
Silver Leaf $30 copay after deductible
Silver Leaf Premier $35 copay not subject to deductible
Silver Leaf Premier Plus $35 copay not subject to deductible
Vision Exams Adult
Silver Leaf not covered
Silver Leaf Premier $35 copay after deductible
Silver Leaf Premier Plus $35 copay after deductible
Vision Exams Pediatrics (up to Age 19)
Silver Leaf $30 copay after deductible
Silver Leaf Premier $35 copay after deductible
Silver Leaf Premier Plus $35 copay after deductible
Telemedicine (Teladoc)
Silver Leaf $0 copay
Silver Leaf Premier $0 copay
Silver Leaf Premier Plus $0 copay
Specialist Visit
Silver Leaf $65 copay not subject to deductible for the first visit (PCP, specialist, outpatient mental health/substance use disorder, chiropractor, allergy, Applied Behavioral Analysis (ABA), or second-opinion visit)
$65 copay after deductible for additional visits
Silver Leaf Premier $65 copay after deductible
Silver Leaf Premier Plus $75 copay not subject to deductible for the first visit (PCP, specialist, outpatient mental health/substance use disorder, chiropractor, allergy, Applied Behavioral Analysis (ABA), or second-opinion visit)
$65 copay after deductible for additional visits
Retail Health Clinic
Silver Leaf $30 copay after deductible
Silver Leaf Premier $35 copayment not subject to deductible
Silver Leaf Premier Plus $35 copay not subject to deductible
Urgent Care
Silver Leaf $70 copay after deductible
Silver Leaf Premier $70 copay after deductible
Silver Leaf Premier Plus $70 copay after deductible
Emergency Room
Silver Leaf $275 copay after deductible
Silver Leaf Premier $500 copay after deductible
Silver Leaf Premier Plus $500 copay after deductible
Ambulance
Silver Leaf $150 copay after deductible
Silver Leaf Premier $150 copay after deductible
Silver Leaf Premier Plus $150 copay after deductible
Surgeon
Silver Leaf $150 copay after deductible
Silver Leaf Premier $150 copay after deductible
Silver Leaf Premier Plus $150 copay after deductible
Outpatient Facility
Silver Leaf $150 copay after deductible
Silver Leaf Premier $150 copay after deductible
Silver Leaf Premier Plus $150 copay after deductible
Inpatient Hospital Stay
Silver Leaf $1,500 copay per admission after deductible
Silver Leaf Premier $1,500 copay per admission after deductible
Silver Leaf Premier Plus $1,500 copay per admission after deductible

Prescription drug benefits

Silver Leaf
Silver Leaf Premier
Silver Leaf Premier Plus
Generic Drugs (Tier 1)
Silver Leaf $15 copay not subject to deductible
Silver Leaf Premier $10 copay not subject to deductible
Silver Leaf Premier Plus $15 copay not subject to deductible
Brand Name Preferred (Tier 2)
Silver Leaf $40 copay not subject to deductible
Silver Leaf Premier $55 copay not subject to deductible
Silver Leaf Premier Plus $55 copay not subject to deductible
Brand Name Non-Preferred (Tier 3)
Silver Leaf $75 copay not subject to deductible
Silver Leaf Premier $100 copay not subject to deductible
Silver Leaf Premier Plus $100 copay not subject to deductible
90-Day Mail-Order Supply for Generic (Tier 1)
Silver Leaf $37.50 copay not subject to deductible
Silver Leaf Premier $20 copay not subject to deductible
Silver Leaf Premier Plus $30 copay not subject to deductible

Additional benefits

24/7 access to telemedicine with Teladoc

Talk to a doctor any time—for a $0 copay. Connect with board-certified doctors through video chat or phone for prescriptions, help diagnosing and treating non-emergency conditions, and more. Access to dermatologists is also available.

Active&Fit ExerciseRewards™ program

Physical activity is one of the simplest ways to stay healthy, and Healthfirst makes it even more rewarding! With the Active&Fit ExerciseRewards program, you can earn up to $200 every six months if you visit a qualifying fitness center at least 50 days during the same six-month reward period.

The Active&Fit ExerciseRewards program makes working out affordable, too! For just $28/month, you get access to thousands of participating fitness centers. Premium fitness center options are available for additional monthly fees. Track your activity, monitor your progress, achieve your fitness goals, and so much more!

Plan documents

General plan information

•
  • Federal Poverty Guidelines
•
  • Summary of Benefits and Coverage - Silver Leaf Premier Plus (350 - 400% FPL)
•
  • Summary of Benefits and Coverage - Silver Leaf Premier (350 - 400% FPL)
•

Prescription drug information

•
  • Comprehensive Formulary (List of Covered Drugs)
See all plan documents Find member forms

Frequently asked questions

Also known as Qualified Health Plans (QHP), NY Marketplace insurance plans:

  • Are certified by the Health Insurance Marketplace
  • Provide essential health benefits
  • Follow established limits on cost sharing (e.g., deductibles, copays, and out-of-pocket maximums)
  • Meet the Affordable Care Act requirement for having health coverage, known as “minimum essential coverage”

You may qualify for a Marketplace insurance plan if you are:

  • A New York State resident
  • Lawfully present in the U.S.
  • Not eligible for Medicaid, an Essential Plan, or Child Health Plus

Yes! You can apply to lower the cost of your health insurance and see if you qualify for free or low-cost coverage from Medicaid, the Essential Plan, or Child Health Plus. Here’s how:

Disclaimers

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.

Coverage is provided by Healthfirst PHSP, Inc.
Plans contain exclusions and limitations.

ATENCIÓN: Dispone de servicios de asistencia lingüística y otras ayudas, gratis. Llame al 1-866-305-0408 (TTY 1-888-867-4132).

请注意:您可以免费获得语言协助服务和其他辅助服务。请致电 1-866-305-0408 (TTY 1‑888‑542‑3821)。

Telemedicine (Teladoc Health) 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). If you see an in-network primary care provider (PCP) or specialist through telehealth, either online or by phone, your normal cost-sharing amounts apply.

*Up to $400 during coverage year; up to an additional $200 during coverage year for spouse.

Last update November 1, 2026 @ 3:15 am

Silver Leaf Plan highlights

No-cost annual checkups

Preventive and wellness visits

Hospital, emergency room, and urgent care visits

Lab tests and x-rays

Prescription drug coverage

Maternity and newborn coverage

Optional dental and vision coverage

24/7 access to care with telemedicine (Teladoc)

Physical, occupational, and speech therapy

Annual gym membership reimbursement*

Costs and plan details

Silver Leaf
Silver Leaf Premier
Silver Leaf Premier Plus
Premium
Monthly premium costs depend on household income and size
Deductible (Individual)
Silver Leaf $2,450
Silver Leaf Premier $3,500
Silver Leaf Premier Plus $2,100
Deductible (Family)
Silver Leaf $4,900
Silver Leaf Premier $7,000
Silver Leaf Premier Plus $4,200
Eligible Age
Under 65
Under 65
Under 65
Eligible Service Areas
Within New York City’s five boroughs (the Bronx, Brooklyn, Manhattan, Queens, and Staten Island), Long Island, and Westchester.
Maximum Out-of-Pocket (Individual)
Silver Leaf $10,150
Silver Leaf Premier $9,200
Silver Leaf Premier Plus $9,200
Maximum Out-of-Pocket (Family)
Silver Leaf $20,300
Silver Leaf Premier $18,400
Silver Leaf Premier Plus $18,400
Your Annual Checkup
Silver Leaf $0 copay
Silver Leaf Premier $0 copay
Silver Leaf Premier Plus $0 copay
Primary Care Provider (PCP) Visit
Silver Leaf $30 copay not subject to deductible for the first visit (PCP, specialist, outpatient mental health/substance use disorder, chiropractor, allergy, Applied Behavioral Analysis (ABA), or second-opinion visit)
$30 copay after deductible for additional visits
Silver Leaf Premier $40 copay not subject to deductible
Silver Leaf Premier Plus $30 copay not subject to deductible for the first visit (PCP, specialist, outpatient mental health/substance use disorder, chiropractor, allergy, Applied Behavioral Analysis (ABA), or second-opinion visit)
$30 copay after deductible for additional visits
Dental Care Adult
Silver Leaf not covered
Silver Leaf Premier $40 copay not subject to deductible
Silver Leaf Premier Plus $30 copay not subject to deductible
Dental Pediatrics (up to Age 19)
Silver Leaf $30 copay after deductible
Silver Leaf Premier $40 copay
Silver Leaf Premier Plus $30 copay not subject to deductible
Vision Exams Adult
Silver Leaf not covered
Silver Leaf Premier $40 copay after deductible
Silver Leaf Premier Plus $30 copay after deductible
Vision Exams Pediatrics (up to Age 19)
Silver Leaf $30 copay after deductible
Silver Leaf Premier $40 copay after deductible
Silver Leaf Premier Plus $30 copay after deductible
Telemedicine (Teladoc)
Silver Leaf $0 copay
Silver Leaf Premier $0 copay
Silver Leaf Premier Plus $0 copay
Specialist Visit
Silver Leaf $65 copay not subject to deductible for the first visit (PCP, specialist, outpatient mental health/substance use disorder, chiropractor, allergy, Applied Behavioral Analysis (ABA), or second-opinion visit)
$65 copay after deductible for additional visits
Silver Leaf Premier $60 copay after deductible
Silver Leaf Premier Plus $65 copay not subject to deductible for the first visit (PCP, specialist, outpatient mental health/substance use disorder, chiropractor, allergy, Applied Behavioral Analysis (ABA), or second-opinion visit)
$65 copay after deductible for additional visits
Retail Health Clinic
Silver Leaf $30 copay after deductible
Silver Leaf Premier $40 copay not subject to deductible
Silver Leaf Premier Plus $30 copay not subject to deductible
Urgent Care
Silver Leaf $70 copay after deductible
Silver Leaf Premier $70 copay after deductible
Silver Leaf Premier Plus $70 copay after deductible
Emergency Room
Silver Leaf $500 copay after deductible
Silver Leaf Premier $500 copay after deductible
Silver Leaf Premier Plus $500 copay after deductible
Ambulance
Silver Leaf $150 copay after deductible
Silver Leaf Premier $150 copay after deductible
Silver Leaf Premier Plus $150 copay after deductible
Surgeon
Silver Leaf $150 copay after deductible
Silver Leaf Premier $150 copay after deductible
Silver Leaf Premier Plus $150 copay after deductible
Outpatient Facility
Silver Leaf $150 copay after deductible
Silver Leaf Premier $150 copay after deductible
Silver Leaf Premier Plus $150 copay after deductible
Inpatient Hospital Stay
Silver Leaf $1,500 copay per admission after deductible
Silver Leaf Premier $1,500 copay per admission after deductible
Silver Leaf Premier Plus $1,500 copay per admission after deductible

Prescription drug benefits

Silver Leaf
Silver Leaf Premier
Silver Leaf Premier Plus
Generic Drugs (Tier 1)
Silver Leaf $15 copay not subject to deductible
Silver Leaf Premier $10 copay not subject to deductible
Silver Leaf Premier Plus $15 copay not subject to deductible
Brand Name Preferred (Tier 2)
Silver Leaf $40 copay not subject to deductible
Silver Leaf Premier $55 copay not subject to deductible
Silver Leaf Premier Plus $55 copay not subject to deductible
Brand Name Non-Preferred (Tier 3)
Silver Leaf $75 copay not subject to deductible
Silver Leaf Premier 50% coinsurance not subject to deductible
Silver Leaf Premier Plus 50% coinsurance not subject to deductible
90-Day Mail-Order Supply for Generic (Tier 1)
Silver Leaf $37.50 copay not subject to deductible
Silver Leaf Premier $20 copay not subject to deductible
Silver Leaf Premier Plus $30 copay not subject to deductible

Additional benefits

24/7 access to telemedicine with Teladoc

Talk to a doctor any time—for a $0 copay. Connect with board-certified doctors through video chat or phone for prescriptions, help diagnosing and treating non-emergency conditions, and more. Access to dermatologists is also available.

Active&Fit ExerciseRewards™ program

Physical activity is one of the simplest ways to stay healthy, and Healthfirst makes it even more rewarding! With the Active&Fit ExerciseRewards program, you can earn up to $200 every six months if you visit a qualifying fitness center at least 50 days during the same six-month reward period.

The Active&Fit ExerciseRewards program makes working out affordable, too! For just $28/month, you get access to thousands of participating fitness centers. Premium fitness center options are available for additional monthly fees. Track your activity, monitor your progress, achieve your fitness goals, and so much more!

Plan documents

General plan information

•
  • Federal Poverty Guidelines
•
  • Summary of Benefits and Coverage - Silver Leaf Premier Plus (>400% FPL)
•
•

Prescription drug information

•
  • Comprehensive Formulary (List of Covered Drugs)
See all plan documents Find member forms

Frequently asked questions

Also known as Qualified Health Plans (QHP), NY Marketplace insurance plans:

  • Are certified by the Health Insurance Marketplace
  • Provide essential health benefits
  • Follow established limits on cost sharing (e.g., deductibles, copays, and out-of-pocket maximums)
  • Meet the Affordable Care Act requirement for having health coverage, known as “minimum essential coverage”

You may qualify for a Marketplace insurance plan if you are:

  • A New York State resident
  • Lawfully present in the U.S.
  • Not eligible for Medicaid, an Essential Plan, or Child Health Plus

Yes! You can apply to lower the cost of your health insurance and see if you qualify for free or low-cost coverage from Medicaid, the Essential Plan, or Child Health Plus. Here’s how:

Disclaimers

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.

Coverage is provided by Healthfirst PHSP, Inc.
Plans contain exclusions and limitations.

ATENCIÓN: Dispone de servicios de asistencia lingüística y otras ayudas, gratis. Llame al 1-866-305-0408 (TTY 1-888-867-4132).

请注意:您可以免费获得语言协助服务和其他辅助服务。请致电 1-866-305-0408 (TTY 1‑888‑542‑3821)。

Telemedicine (Teladoc Health) 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). If you see an in-network primary care provider (PCP) or specialist through telehealth, either online or by phone, your normal cost-sharing amounts apply.

*Up to $400 during coverage year; up to an additional $200 during coverage year for spouse.

Last update November 1, 2026 @ 3:15 am

Bronze Leaf Plan highlights

No-cost annual checkups

Preventive and wellness visits

Hospital, emergency room, and urgent care visits

Lab tests and x-rays

Prescription drug coverage

Maternity and newborn coverage

Optional dental and vision coverage

24/7 access to care with telemedicine (Teladoc)

Physical, occupational, and speech therapy

Annual gym membership reimbursement*

Costs and plan details

Bronze Leaf
Bronze Leaf Premier
Premium
Monthly premium costs depend on household income and size
Monthly premium costs depend on household income and size
Deductible (Individual)
Bronze Leaf $4,125
Bronze Leaf Premier $5,000
Deductible (Family)
Bronze Leaf $8,250
Bronze Leaf Premier $10,000
Eligible Age
Under 65
Under 65
Eligible Service Areas
Within New York City’s five boroughs (the Bronx, Brooklyn, Manhattan, Queens, and Staten Island), Long Island, and Westchester.
Maximum Out-of-Pocket (Individual)
Bronze Leaf $10,150
Bronze Leaf Premier $9,600
Maximum Out-of-Pocket (Family)
Bronze Leaf $20,300
Bronze Leaf Premier $19,200
Your Annual Checkup
Bronze Leaf $0 copay
Bronze Leaf Premier $0 copay
Primary Care Provider (PCP) Visit
Bronze Leaf $50 copay not subject to deductible for first three visits (any combination of PCP, specialist, or outpatient mental health/substance use disorder)
$50 copay after deductible for additional visits
Bronze Leaf Premier $50 copay not subject to deductible
Dental Care Adult
Bronze Leaf Not covered
Bronze Leaf Premier $50 copay after deductible
Dental Pediatrics (up to Age 19)
Bronze Leaf $50 copay after deductible
Bronze Leaf Premier $50 copay after deductible
Vision Exams Adult
Bronze Leaf Not covered
Bronze Leaf Premier $50 copay after deductible
Vision Exams Pediatrics (up to Age 19)
Bronze Leaf $50 copay after deductible
Bronze Leaf Premier $50 copay after deductible
Telemedicine (Teladoc)
Bronze Leaf $0 copay
Bronze Leaf Premier $0 copay
Specialist Visit
Bronze Leaf $75 copay not subject to deductible for first three visits (any combination of PCP, specialist, or outpatient mental health/substance use disorder)
$75 copay after deductible for additional visits
Bronze Leaf Premier $75 copay after deductible
Retail Health Clinic
Bronze Leaf $50 copay after deductible
Bronze Leaf Premier $50 copay not subject to deductible
Urgent Care
Bronze Leaf $75 copay after deductible
Bronze Leaf Premier $75 copay after deductible
Emergency Room
Bronze Leaf $500 copay after deductible
Bronze Leaf Premier $500 copay after deductible
Ambulance
Bronze Leaf $300 copay after deductible
Bronze Leaf Premier $300 copay after deductible
Surgeon
Bronze Leaf $150 copay after deductible
Bronze Leaf Premier $150 copay after deductible
Outpatient Facility
Bronze Leaf $150 copay after deductible
Bronze Leaf Premier $150 copay after deductible
Inpatient Hospital Stay
Bronze Leaf $1,500 copay per admission after deductible
Bronze Leaf Premier $1,500 copay per admission after deductible

Prescription drug benefits

Bronze Leaf
Bronze Leaf Premier
Generic Drugs (Tier 1)
Bronze Leaf $10 copay after deductible
Bronze Leaf Premier $10 copay after deductible
Brand Name Preferred (Tier 2)
Bronze Leaf $35 copay after deductible
Bronze Leaf Premier $35 copay after deductible
Brand Name Non-Preferred (Tier 3)
Bronze Leaf $70 copay after deductible
Bronze Leaf Premier $70 copay after deductible
90-Day Mail-Order Supply for Generic (Tier 1)
Bronze Leaf $25 copay after deductible
Bronze Leaf Premier $20 copay after deductible

Additional benefits

24/7 access to telemedicine with Teladoc

Talk to a doctor any time—for a $0 copay. Connect with board-certified doctors through video chat or phone for prescriptions, help diagnosing and treating non-emergency conditions, and more. Access to dermatologists is also available.

Active&Fit ExerciseRewards™ program

Physical activity is one of the simplest ways to stay healthy, and Healthfirst makes it even more rewarding! With the Active&Fit ExerciseRewards program, you can earn up to $200 every six months if you visit a qualifying fitness center at least 50 days during the same six-month reward period.

The Active&Fit ExerciseRewards program makes working out affordable, too! For just $28/month, you get access to thousands of participating fitness centers. Premium fitness center options are available for additional monthly fees. Track your activity, monitor your progress, achieve your fitness goals, and so much more!

Plan documents

General plan information

•
•

Prescription drug information

•
  • Comprehensive Formulary (List of Covered Drugs)
See all plan documents Find member forms

Frequently asked questions

Also known as Qualified Health Plans (QHP), NY Marketplace insurance plans:

  • Are certified by the Health Insurance Marketplace
  • Provide essential health benefits
  • Follow established limits on cost sharing (e.g., deductibles, copays, and out-of-pocket maximums)
  • Meet the Affordable Care Act requirement for having health coverage, known as “minimum essential coverage”

You may qualify for a Marketplace insurance plan if you are:

  • A New York State resident
  • Lawfully present in the U.S.
  • Not eligible for Medicaid, an Essential Plan, or Child Health Plus

Yes! You can apply to lower the cost of your health insurance and see if you qualify for free or low-cost coverage from Medicaid, the Essential Plan, or Child Health Plus. Here’s how:

Disclaimers

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.

Coverage is provided by Healthfirst PHSP, Inc.
Plans contain exclusions and limitations.

ATENCIÓN: Dispone de servicios de asistencia lingüística y otras ayudas, gratis. Llame al 1-866-305-0408 (TTY 1-888-867-4132).

请注意:您可以免费获得语言协助服务和其他辅助服务。请致电 1-866-305-0408 (TTY 1‑888‑542‑3821)。

Telemedicine (Teladoc Health) 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). If you see an in-network primary care provider (PCP) or specialist through telehealth, either online or by phone, your normal cost-sharing amounts apply.

*Up to $400 during coverage year; up to an additional $200 during coverage year for spouse.

Last update November 1, 2026 @ 3:15 am

Green Leaf Plan highlights

No-cost annual checkups

Preventive and wellness visits

Hospital, emergency room, and urgent care visits

Lab tests and x-rays

Prescription drug coverage

Maternity and newborn coverage

Optional dental and vision coverage

24/7 access to care with telemedicine (Teladoc)

Physical, occupational, and speech therapy

Annual gym membership reimbursement*

Costs and plan details

Green Leaf
Premium
Monthly premium costs depend on household income and size
Deductible (Individual)
$10,600
Deductible (Family)
$21,200
Eligible Age
Individuals under 30
Eligible Service Areas
Within New York City’s five boroughs (the Bronx, Brooklyn, Manhattan, Queens, and Staten Island), Long Island and Westchester.
Maximum Out-of-Pocket (Individual)
$10,600
Maximum Out-of-Pocket (Family)
$21,200
Your Annual Checkup
$0 copay
Primary Care Provider (PCP) Visit
$0 copay not subject to deductible for first three visits (PCP, outpatient MH/SUD or any combination);
0% coinsurance after deductible for additional visits
Dental Pediatrics (up to Age 19)
0% coinsurance after deductible
Vision Exams Pediatrics (up to Age 19)
0% coinsurance after deductible
Telemedicine (Teladoc)
$0 copay after deductible
Specialist Visit
0% coinsurance after deductible
Retail Health Clinic
0% coinsurance after deductible
Urgent Care
0% coinsurance after deductible
Emergency Room
0% coinsurance after deductible
Ambulance
0% coinsurance after deductible
Surgeon
0% coinsurance after deductible
Outpatient Facility
0% coinsurance after deductible
Inpatient Hospital Stay
0% coinsurance after deductible

Prescription drug benefits

Green Leaf
Generic Drugs (Tier 1)
0% coinsurance after deductible
Brand Name Preferred (Tier 2)
0% coinsurance after deductible
Brand Name Non-Preferred (Tier 3)
0% coinsurance after deductible
90-Day Mail-Order Supply for Generic (Tier 1)
0% coinsurance after deductible

Additional benefits

24/7 access to telemedicine with Teladoc

Talk to a doctor any time—for a $0 copay. Connect with board-certified doctors through video chat or phone for prescriptions, help diagnosing and treating non-emergency conditions, and more. Access to dermatologists is also available.

Active&Fit ExerciseRewards™ program

Physical activity is one of the simplest ways to stay healthy, and Healthfirst makes it even more rewarding! With the Active&Fit ExerciseRewards program, you can earn up to $200 every six months if you visit a qualifying fitness center at least 50 days during the same six-month reward period.

The Active&Fit ExerciseRewards program makes working out affordable, too! For just $28/month, you get access to thousands of participating fitness centers. Premium fitness center options are available for additional monthly fees. Track your activity, monitor your progress, achieve your fitness goals, and so much more!

Plan documents

General plan information

•

Prescription drug information

•
  • Comprehensive Formulary (List of Covered Drugs)
See all plan documents Find member forms

Frequently asked questions

Also known as Qualified Health Plans (QHP), NY Marketplace insurance plans:

  • Are certified by the Health Insurance Marketplace
  • Provide essential health benefits
  • Follow established limits on cost sharing (e.g., deductibles, copays, and out-of-pocket maximums)
  • Meet the Affordable Care Act requirement for having health coverage, known as “minimum essential coverage”

You may qualify for a Marketplace insurance plan if you are:

  • A New York State resident
  • Lawfully present in the U.S.
  • Not eligible for Medicaid, an Essential Plan, or Child Health Plus

Yes! You can apply to lower the cost of your health insurance and see if you qualify for free or low-cost coverage from Medicaid, the Essential Plan, or Child Health Plus. Here’s how:

Disclaimers

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.

Coverage is provided by Healthfirst PHSP, Inc.
Plans contain exclusions and limitations.

ATENCIÓN: Dispone de servicios de asistencia lingüística y otras ayudas, gratis. Llame al 1-866-305-0408 (TTY 1-888-867-4132).

请注意:您可以免费获得语言协助服务和其他辅助服务。请致电 1-866-305-0408 (TTY 1‑888‑542‑3821)。

Telemedicine (Teladoc Health) 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). If you see an in-network primary care provider (PCP) or specialist through telehealth, either online or by phone, your normal cost-sharing amounts apply.

*Up to $400 during coverage year; up to an additional $200 during coverage year for spouse.

Last update November 1, 2026 @ 3:15 am

Learn about enrollment

Call to speak with a sales representative
1-844-434-7785

TTY English: 1-888-542-3821

TTY Español: 1-888-867-4132

Monday to Friday, 9am–6pm

Request a call

Our sales team will call you within one business day.

Request a call
Schedule an appointment

We can help you enroll by phone, video chat, or in person.

Schedule an appointment

You can also go to the NY State of Health website to view your choices, or call the NY State of Health customer service center at 1-855-355-5777.

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Let's talk