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Leaf & Leaf Premier Plans

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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 (Teladoc)*
  • Physical, occupational, and speech therapy
  • Annual gym membership reimbursement**
  • 2022
Tier
Platinum Leaf
Platinum Leaf Premier
Summary of Benefits and Coverage (PDF)
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English
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Español 中文
Premium
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), Long Island and Westchester
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
Telemedicine (Teladoc)
$0 copay
$0 copay
Costs & Benefits
Contact Us Tier
Platinum Leaf
Platinum Leaf Premier
Deductible (Individual)
$0
$0
Maximum Out-of-Pocket (Individual)
$2,000
$2,000
Deductible (Family)
$0
$0
Maximum Out-of-Pocket (Family)
$4,000
$4,000
Your Annual Checkup (Preventive Care)
$0 copay
$0 copay
Primary Care Provider (PCP) Visit
$15 copay
$10 copay
Specialist Visit
$35 copay
$40 copay
Retail Health Clinic
$15 copay
$10 copay
Urgent Care
$55 copay
$55 copay
Emergency Room
$100 copay
$100 copay
Ambulance
$100 copay
$100 copay
Surgeon
$100 copay
$100 copay
Outpatient Facility
$100 copay
$100 copay
Inpatient Hospital Stay
$500 copay per admission
$500 copay per admission
Prescriptions
Generic Drugs (Tier 1)
$10 copay
$5 copay
Brand Name Preferred (Tier 2)
$30 copay
$50 copay
Brand Name Non-Preferred (Tier 3)
$60 copay
$85 copay
90-Day Mail-Order Supply for Generic (Tier 1)
$25 copay
$10 copay
Covered Prescription Drugs (Formulary) English
Tier
Gold Leaf
Gold Leaf Premier
Gold Leaf Premier Plus
Summary of Benefits and Coverage (PDF)
English
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Español 中文
English
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Español 中文
English
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Español 中文
Premium
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), Long Island and Westchester
Dental Care
Pediatric – $25 copay after deductible
Adult – not covered
Pediatric – $20 copay
Adult – $20 copay
Pediatric – $20 copay
Adult – $20 copay
Vision Exams
Pediatric – $25 copay after deductible
Adult – not covered
Pediatric – $20 copay after deductible
Adult – $20 copay after deductible
Pediatric – $20 copay after deductible
Adult – $20 copay after deductible
Telemedicine (Teladoc)
$0 copay
$0 copay
$0 copay
Costs & Benefits
Contact Us Tier
Gold Leaf
Gold Leaf Premier
Gold Leaf Premier Plus
Deductible (Individual)
$600
$850
$700
Maximum Out-of-Pocket (Individual)
$4,000
$6,000
$6,000
Deductible (Family)
$1,200
$1,700
$1,400
Maximum Out-of-Pocket (Family)
$8,000
$12,000
$12,000
Your Annual Checkup (Preventive Care)
$0 copay
$0 copay
$0 copay
Primary Care Provider (PCP) Visit
$25 copay after deductible
$20 copay
$20 copay
Specialist Visit
$40 copay after deductible
$40 copay after deductible
$40 copay after deductible
Retail Health Clinic
$25 copay after deductible
$20 copay
$20 copay
Urgent Care
$60 copay after deductible
$60 copay after deductible
$60 copay after deductible
Emergency Room
$150 copay after deductible
$175 copay after deductible
$250 copay after deductible
Ambulance
$150 copay after deductible
$150 copay after deductible
$150 copay after deductible
Surgeon
$100 copay after deductible
$100 copay after deductible
$100 copay after deductible
Outpatient Facility
$100 copay after deductible
$100 copay after deductible
$100 copay after deductible
Inpatient Hospital Stay
$1,000 per admission after deductible
$1,000 per admission after deductible
$1,000 per admission after deductible
Prescriptions
Generic Drugs (Tier 1)
$10 copay
$7 copay
$7 copay
Brand Name Preferred (Tier 2)
$35 copay
$50 copay
$50 copay
Brand Name Non-Preferred (Tier 3)
$70 copay
$100 copay
$100 copay
90-Day Mail-Order Supply for Generic (Tier 1)
$25 copay
$14 copay
$14 copay
Covered Prescription Drugs (Formulary) English
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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
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100% - 150% above FPL 150% - 200% above FPL 200% - 250% above FPL > 250% above FPL
Silver Leaf Premier
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100% - 150% above FPL 150% - 200% above FPL 200% - 250% above FPL > 250% above FPL
Silver Leaf Premier Plus
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100% - 150% above FPL 150% - 200% above FPL 200% - 250% above FPL > 250% above FPL
Summary of Benefits and Coverage (PDF)
Premium
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), Long Island and Westchester
Dental Care
Vision Exams
Telemedicine (Teladoc)
Costs & Benefits
Contact Us Tier
Silver Leaf
Silver Leaf Premier
Silver Leaf Premier Plus
Deductible (Individual)
Maximum Out-of-Pocket (Individual)
Deductible (Family)
Maximum Out-of-Pocket (Family)
Your Annual Checkup (Preventive Care)
Primary Care Provider (PCP) Visit
Specialist Visit
Retail Health Clinic
Urgent Care
Emergency Room
Ambulance
Surgeon
Outpatient Facility
Inpatient Hospital Stay
Prescriptions
Generic Drugs (Tier 1)
Brand Name Preferred (Tier 2)
Brand Name Non-Preferred (Tier 3)
90-Day Mail-Order Supply for Generic (Tier 1)
Covered Prescription Drugs (Formulary) English
Tier
Bronze Leaf
Bronze Leaf Premier
Summary of Benefits and Coverage (PDF)
English
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Español 中文
English
More Languages dropdown arrow
Español 中文
Premium
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), Long Island and Westchester
Dental Care
Pediatric – $50 copay after deductible
Adult – not covered
Pediatric – $50 copay after deductible
Adult - $50 copay after deductible
Vision Exams
Pediatric – $50 copay after deductible
Adult – not covered
Pediatric – $50 copay after deductible
Adult - $50 copay after deductible
Telemedicine (Teladoc)
$0 copay
$0 copay
Costs & Benefits
Contact Us Tier
Bronze Leaf
Bronze Leaf Premier
Deductible (Individual)
$4,700
$5,250
Maximum Out-of-Pocket (Individual)
$8,700
$8,700
Deductible (Family)
$9,400
$10,500
Maximum Out-of-Pocket (Family)
$17,400
$17,400
Your Annual Checkup (Preventive Care)
$0 copay
$0 copay
Primary Care Provider (PCP) Visit
$50 copay not subject to deductible for first 3 visits (any combination of PCP, specialist or outpatient mental health/substance use disorder)

$50 copay after deductible for additional visits
$50 copay
Specialist Visit
$75 copay not subject to deductible for first 3 visits (any combination of PCP, specialist or outpatient mental health/substance use disorder)

$75 copay after deductible for additional visits
$75 copay after deductible
Retail Health Clinic
$50 copay after deductible
$50 copay
Urgent Care
$75 copay after deductible
$75 copay after deductible
Emergency Room
$500 copay after deductible
$500 copay after deductible
Ambulance
$300 copay after deductible
$300 copay after deductible
Surgeon
$150 copay after deductible
$150 copay after deductible
Outpatient Facility
$150 copay after deductible
$150 copay after deductible
Inpatient Hospital Stay
$1,500 copay per admission after deductible
$1,500 copay per admission after deductible
Prescriptions
Generic Drugs (Tier 1)
$10 copay after deductible
$10 copay after deductible
Brand Name Preferred (Tier 2)
$35 copay after deductible
$35 copay after deductible
Brand Name Non-Preferred (Tier 3)
$70 copay after deductible
$70 copay after deductible
90-Day Mail-Order Supply for Generic (Tier 1)
$25 copay after deductible
$25 copay after deductible
Covered Prescription Drugs (Formulary) English
Tier
Green Leaf
Summary of Benefits and Coverage (PDF)
English
More Languages dropdown arrow
Español 中文
Premium
Monthly premium costs depend on household income and size
Get a Quote
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
Dental Care
$0 copay after deductible; Pediatrics Only - for members up to Age 19
Vision Exams
$0 copay after deductible; Pediatrics Only - for members up to Age 19
Telemedicine (Teladoc)
$0 copay
Costs & Benefits
Contact Us Tier
Green Leaf
Deductible (Individual)
$8,700
Maximum Out-of-Pocket (Individual)
$8,700
Deductible (Family)
$17,400
Maximum Out-of-Pocket (Family)
$17,400
Your Annual Checkup (Preventive Care)
$0 copay
Primary Care Provider (PCP) Visit
$0 copay for first 3 visits (any combination of PCP, specialist, or outpatient mental health/substance use disorder)

$0 copay after deductible for additional visits
Specialist Visit
$0 copay after deductible
Retail Health Clinic
$0 copay after deductible
Urgent Care
$0 copay after deductible
Emergency Room
$0 copay after deductible
Ambulance
$0 copay after deductible
Surgeon
$0 copay after deductible
Outpatient Facility
$0 copay after deductible
Inpatient Hospital Stay
$0 copay after deductible
Prescriptions
Generic Drugs (Tier 1)
$0 copay after deductible
Brand Name Preferred (Tier 2)
$0 copay after deductible
Brand Name Non-Preferred (Tier 3)
$0 copay after deductible
90-Day Mail-Order Supply for Generic (Tier 1)
$0 copay after deductible
Covered Prescription Drugs (Formulary) English

The benefit information provided is a brief summary, not a complete description, of benefits. For more information, contact the plan.

Coverage is provided by Healthfirst Health Plan, Inc., Healthfirst PHSP, Inc., and/or Healthfirst Insurance Company, Inc. (together, “Healthfirst”). Plans contain exclusions and limitations.

Additional Benefits

  • Additional benefit image

    24/7 Access to Telemedicine with Teladoc*

    Talk to a doctor any time—for a $0 copay. Visit with board-certified doctors through video chat or phone for prescriptions, treatment of non-emergency health issues, and more. Access to dermatologists is also available.

    *Telemedicine isn’t a replacement for your Primary Care Provider (PCP). Your PCP should always be your first choice for care (both in-person and virtual visits).

  • Additional benefit image

    Active & Fit Direct

    Healthfirst makes working out affordable too! For just $25/month, you get a standard membership to a fitness center in your area. Premium fitness center options are available for an additional fee. Track your activity, monitor your progress, achieve your fitness goals, and so much more! Visit activeandfitdirect.com to learn more.

  • Additional benefit image

    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 $200 every six months if you visit a qualifying fitness center at least 50 days during the same six-month reward period. Contact ExerciseRewards at 1-877-810-2746 to learn more about qualifying fitness centers.

Additional Benefits

  • 24/7 Access to Telemedicine with Teladoc*

    Additional benefits dropdown arrow

  • Active & Fit Direct

    Additional benefits dropdown arrow

  • ExerciseRewards™ Program

    Additional benefits dropdown arrow

Frequently Asked
Questions

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Support When You Need It

We're happy to answer your questions.

Learn about enrollment

1-844-488-1486

Monday to Friday, 9am–8pm

TTY English: 1-888-542-3821

TTY Español: 1-888-867-4132

Member Services

1-888-250-2220

Monday to Friday, 9am—8pm

TTY English: 1-888-542-3821

TTY Español: 1-888-867-4132

Can’t talk right now?

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

You can also visit our Virtual Community Office to connect with a local Healthfirst representative or to find a community office near you.

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

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