Medicaid Managed Care

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A Medicaid plan with a $0 monthly plan premium and low or no copays for doctor visits, lab tests, prescription drugs, 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.

The way that you get your pharmacy benefits is NOT changing on May 1, 2021
More Details - English | Spanish | Chinese

Plan Highlights:

  • No-cost annual checkups
  • Hospital, emergency room, retail health clinic, and urgent care visits
  • Prescription and over-the-counter nonprescription drug coverage*
  • 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)*
  • 2021
Medicaid Managed Care
Summary of Benefits and Coverage (PDF)
English
Comprehensive Formulary
Comprehensive Formulary (List of Covered Drugs)
English
Premium
$0
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, Orange, Rockland, and Sullivan counties
Other Eligibility Requirements
Meet the Medicaid Managed Care income requirements. Not sure if you’re eligible? Find out now
Dental Cleanings
Pediatric – $0 copay
Adult - $0 copay
Vision Exams
Pediatric – $0 copay
Adult - $0 copay
Telemedicine (Teladoc)
$0 copay
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*Some copays may apply.

**LogistiCare® 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).

  • Additional benefit image

    Urgent Care Center Network

    Get the care you need when you need it at an urgent care center in our network–no appointment needed. Urgent care centers offer late-night and weekend hours, often with faster service at a lower cost than the Emergency Room (ER).

    Visit an in-network urgent care center to get help for non-emergency conditions like earache, upset stomach, sprains, stitches, and more.

Additional Benefits

  • 24/7 Access to Telemedicine with Teladoc*

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  • Urgent Care Center Network

    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 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.

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