Medicaid Managed Care is a health insurance option for eligible New Yorkers with limited income.
With Medicaid Managed Care from Healthfirst, you can access preventive care, doctor visits, hospital services, mental health treatment, maternity care, and more. If you qualify, you can take care of your health and your family's health for a $0 monthly premium and low or $0 copays for covered care.
No-cost annual checkups
Hospital, emergency room, retail health clinic, and urgent care visits
Maternity coverage, plus your newborn is automatically enrolled in Medicaid
Hearing, vision, and dental coverage
Transportation to and from doctor appointments for covered services*
Physical, occupational, and speech therapy
Health and wellness programs
24/7 access to care with telemedicine (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.
Taking care of your eyes doesn’t just mean having clear vision. An annual eye exam can help detect a number of health risks, such as diabetes, thyroid disease, high blood pressure, and other conditions. Healthfirst has made it easy for our members to take advantage of this often overlooked preventive service by providing access to comprehensive vision care.
Healthfirst believes that providing you with good dental care is important to your overall healthcare. Covered dental services include regular and routine services such as preventive dental checkups, cleanings, X-rays, fillings, and other services to check for any changes or abnormalities that may require treatment and/or follow-up care for you. You do not need a referral from your PCP to see a dentist.
ILS are services or settings that are not covered by Medicaid but are medically appropriate substitutes for covered services or settings.
Covered ILS Benefit: Psychiatric Admissions
You have covered care options than can be used instead of Inpatient Psychiatric services available in some hospitals.
The alternative care option is a short-term intensive stay in a private Institution for Mental Disease (IMD) licensed by OMH, available only at the following four facilities in the Healthfirst service area:
If you live in New York City, there are several ways to apply for Medicaid. The easiest and fastest methods:
Medicaid eligibility is based on a combination of income, household size, age, disability status, pregnancy status, and residency. While Medicaid is a federal program, each state—including New York—sets specific income limits within federal guidelines. In New York, many adults qualify if their income falls within the state’s Medicaid limits. See income eligibility.
Yes. Medicaid covers transportation to medical appointments for eligible members who do not have a safe or reliable way to get there.
If you are enrolled in Medicaid Managed Care plan and do not have a way to safely get to your medical appointment, you may qualify for transportation assistance. In New York, this benefit is called Non-Emergency Medical Transportation (NEMT).
Transportation must be for a covered medical service. The type of transportation provided depends on your health needs and mobility level.
Medicaid transportation in New York may cover travel to:
Transportation options may include:
Transportation is typically arranged in advance through your Medicaid health plan or the state’s transportation manager. You should request transportation before your appointment whenever possible. Medicaid members should contact Medicaid transportation at the number below:
Service areas:
No. You can visit any in-network dentist and switch to another in-network dentist at any time without notifying Healthfirst. To find a dentist, visit MyHFNY.org or call the Member Services number on the back of your Member ID card.
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 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)。
*Medical Answering Services provide the covered transportation services under your plan.
**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).
No-cost annual checkups
Hospital, emergency room, retail health clinic, and urgent care visits
Maternity coverage, plus your newborn is automatically enrolled in Medicaid
Hearing, vision, and dental coverage
Transportation to and from doctor appointments for covered services*
Physical, occupational, and speech therapy
Health and wellness programs
24/7 access to care with telemedicine (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.
Taking care of your eyes doesn’t just mean having clear vision. An annual eye exam can help detect a number of health risks, such as diabetes, thyroid disease, high blood pressure, and other conditions. Healthfirst has made it easy for our members to take advantage of this often overlooked preventive service by providing access to comprehensive vision care.
Healthfirst believes that providing you with good dental care is important to your overall healthcare. Covered services include regular and routine dental services such as preventive dental checkups, cleanings, X-rays, fillings, and other services to check for any changes or abnormalities that may require treatment and/or follow-up care for you. You do not need a referral from your PCP to see a dentist.
ILS are services or settings that are not covered by Medicaid but are medically appropriate substitutes for covered services or settings.
Covered ILS Benefit: Psychiatric Admissions
You have covered care options than can be used instead of Inpatient Psychiatric services available in some hospitals.
The alternative care option is a short-term intensive stay in a private Institution for Mental Disease (IMD) licensed by OMH, available only at the following four facilities in the Healthfirst service area:
Medicaid covers the essential benefits you need to stay healthy, including:
Both! Healthfirst offers health plans for all ages, needs, and incomes, including:
Medicaid is for many low-income New York residents, including:
Keep your child safe by getting them vaccinated. Healthfirst Medicaid Managed Care members under age 19 are covered for both COVID-19 and flu vaccines. To get your child vaccinated, reach out to their doctor, a public health clinic, or your county’s health department. Your child can also get vaccinated at a pharmacy enrolled in both NYRx (the NYS Medicaid Pharmacy program) and in the Vaccines for Children program. Always call first to make sure that the vaccines are ready for your child.
To find a vaccine provider, see the links below.
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 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)。
*Medical Answering Services provide the covered transportation services under your plan.
**Telemedicine (Teladoc) isn't a replacement for your primary care provider (PCP). Your PCP should always be your first choice for care (both in-person and virtual visits).
We can help you enroll by phone, video chat, or in person.
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.