BackMedicaid Managed Care
A Medicaid plan with a $0 monthly plan premium and low or no copays for doctor visits, lab tests, hospitalization, urgent care, emergency care, maternity, dental, vision, hearing, wellness, and more. Sponsored by New York State, this plan is for qualified low-income families and individuals under 65.
Beginning April 1, 2023, all Medicaid members enrolled in Healthfirst Medicaid Managed Care will receive their prescription drugs through NYRx, the Medicaid Pharmacy Program.
Information about the transition of the pharmacy benefit from Healthfirst Medicaid Managed Care to NYRx, the Medicaid Pharmacy Program can be found here.
General information about NYRx, the Medicaid Pharmacy Program can be found here along with information for Members and Providers.
Plan Highlights:
- 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
- NEW - Institution for Mental Disease (IMD) In Lieu of Service (ILS)
- 24/7 access to care with telemedicine (Teladoc)*
- 2023
Plans
The New York State of Health Marketplace rates insurance companies based on member experience, medical care, and health plan administration. The overall quality rating is based on a scale of one to five stars, with five stars being the highest and best rating.
For maximum out-of-pocket pharmacy copay information, visit NYRx, the Medicaid Pharmacy Program
- Preventive Pediatric GuideEnglish
- Women’s Preventive Services
- Full List of Approved Preventive Services
*Some copays may apply.
**ModivCare® and Medical Answering Services provide the covered transportation services under your plan.
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
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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.
*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).
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See better with Healthfirst Vision Benefits
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.
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Dental Care That Keeps You Smiling
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.
Additional Benefits
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24/7 Access to Telemedicine with Teladoc*
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See better with Healthfirst Vision Benefits
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Dental Care That Keeps You Smiling
Frequently Asked
Questions
See All
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Who is eligible to enroll?
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Why should I choose Healthfirst?
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How can I enroll?
Support When You Need It
We’re happy to answer your questions.
Learn about enrollment
1-844-488-1486
Monday to Saturday, 8am–8pm
TTY English: 1-888-542-3821
TTY Español: 1-888-867-4132
Member Services
1-866-463-6743
Monday to Friday, 8am—6pm
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.
We look forward to helping you!
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