Marketplace

Leaf & Leaf Premier Plans

At Healthfirst, you have options. Depending on your needs and your budget, we offer two different levels of coverage for individuals and families under 65. Our standard Leaf plans offer everyday health benefits that cover the essential health protections you and your family need to feel secure. We also offer comprehensive Leaf Premier plans that provide all of the standard benefits, plus adult vision and adult dental care. To find out which plan is right for you, call us today.

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
Physical, occupational, and speech therapy
Annual gym membership reimbursement^**

2020

Tier

Platinum Leaf

Platinum Leaf Premier

Summary of Benefits and Coverage (PDF)

Comprehensive Formulary

Comprehensive Formulary (List of Covered Drugs)

English

Monthly premium costs depend on household income and size

Get a Quote

Eligible Age

Under 65

Eligible Service Areas

Within New York City’s five boroughs (the Bronx, Brooklyn, Manhattan, Queens, and Staten Island) and Long Island

Dental Care

Pediatric – $15 copay

Adult – not covered

Pediatric – $10 copay

Adult – $10 copay

Vision Exams

Pediatric – $15 copay

Adult – not covered

Pediatric – $10 copay

Adult – $10 copay

$0 copay

More Plan Information

Costs & Benefits

Platinum Leaf

Platinum Leaf Premier

(Individual)

$2,000

(Family)

$4,000

Your Annual Checkup ()

$0 copay

$15 copay

$10 copay

$35 copay

$40 copay

Urgent Care

$55 copay

Emergency Room

$100 copay

Ambulance

$100 copay

Surgeon

$100 copay

$500 per admission

$500 copay

Preventive Pediatric GuideEnglish
Women’s Preventive Services
Full List of Approved Preventive Services

Prescriptions

(Tier 1)

$10 copay

$5 copay

(Tier 2)

$30 copay

$50 copay

(Tier 3)

$60 copay

$85 copay

(Tier 1)

$25 copay

$10 copay

(Formulary) English

Tier

Gold Leaf

Gold Leaf Premier

Summary of Benefits and Coverage (PDF)

Comprehensive Formulary

Comprehensive Formulary (List of Covered Drugs)

English

Monthly premium costs depend on household income and size

Get a Quote

Eligible Age

Under 65

Eligible Service Areas

Within New York City’s five boroughs (the Bronx, Brooklyn, Manhattan, Queens, and Staten Island) and Long Island

Dental Care

Pediatric – $25 copay after deductible

Adult – not covered

Pediatric – $20 copay after deductible

Adult – $20 copay after deductible

Vision Exams

Pediatric – $25 copay after deductible

Adult – not covered

Pediatric – $20 copay after deductible

Adult – $20 copay after deductible

$0 copay

More Plan Information

Costs & Benefits

Gold Leaf

Gold Leaf Premier

(Individual)

$600

$900

(Individual)

$4,000

$5,000

(Family)

$1,200

$1,800

(Family)

$8,000

$10,000

Your Annual Checkup ()

$0 copay

$25 copay after deductible

$20 copay

$40 copay after deductible

Urgent Care

$60 copay after deductible

Emergency Room

$150 copay after deductible

$175 copay after deductible

Ambulance

$150 copay after deductible

Surgeon

$100 copay after deductible

$1,000 per admission after deductible

Preventive Pediatric GuideEnglish
Women’s Preventive Services
Full List of Approved Preventive Services

Prescriptions

(Tier 1)

$10 copay

$7 copay

(Tier 2)

$35 copay

$50 copay

(Tier 3)

$70 copay

$100 copay

(Tier 1)

$25 copay

$14 copay

(Formulary) English

Prices vary based on income, please select view.

View current Federal Poverty Guidelines (PDF) to see where you fall. Or Get a Quote

Tier

Silver Leaf

Silver Leaf Premier

Summary of Benefits and Coverage (PDF)

Comprehensive Formulary

Comprehensive Formulary (List of Covered Drugs)

English

Monthly premium costs depend on household income and size

Get a Quote

Eligible Age

Eligible Service Areas

Within New York City’s five boroughs (the Bronx, Brooklyn, Manhattan, Queens, and Staten Island) and Long Island

Dental Care

Vision Exams

More Plan Information

Costs & Benefits

Silver Leaf

Silver Leaf Premier

(Individual)

(Family)

Your Annual Checkup ()

Urgent Care

Emergency Room

Ambulance

Surgeon

Preventive Pediatric GuideEnglish
Women’s Preventive Services
Full List of Approved Preventive Services

Prescriptions

(Tier 1)

(Tier 2)

(Tier 3)

(Tier 1)

Tier

Bronze Leaf

Bronze Leaf Premier

Summary of Benefits and Coverage (PDF)

Comprehensive Formulary

Comprehensive Formulary (List of Covered Drugs)

English

Monthly premium costs depend on household income and size

Get a Quote

Eligible Age

Under 65

Eligible Service Areas

Within New York City’s five boroughs (the Bronx, Brooklyn, Manhattan, Queens, and Staten Island) and Long Island

Dental Care

Pediatric – 50% coinsurance after deductible

Adult – not covered

Pediatric – 50% coinsurance after deductible

Adult - 50% coinsurance after deductible

Vision Exams

Pediatric – 50% coinsurance after deductible

Adult – not covered

Pediatric – 50% coinsurance after deductible

Adult - 50% coinsurance after deductible

$0 copay

More Plan Information

Costs & Benefits

Bronze Leaf

Bronze Leaf Premier

(Individual)

$4,425

$4,300

(Individual)

$8,150

(Family)

$8,850

$8,600

(Family)

$16,300

Your Annual Checkup ()

$0 copay

50% coinsurance after deductible (first 3 visits free)

$35 copay