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Signature (PPO)

A Medicare Advantage plan for those who want the flexibility to see any doctor or hospital in the U.S. that accepts Medicare for medical care.

Plan highlights

$1 copay for preferred generic drugs (30-day supply)

Comprehensive dental coverage

Convenient prescription drug delivery options

Routine vision and hearing exams, $75/year allowance for eyeglasses or contacts, and hearing aids for as low as $0

Worldwide emergency and urgent care coverage with a maximum benefit allowance

A broad network of more than 100,000 participating providers, plus the option to go out of network

Costs

Premium

$55

Deductible

$500

Combined in-network/out-of-network

Copays/Coinsurance
Primary Care Provider Visit

$0 in-network copay

$50 out-of-network copay

Specialist Visit

$40 in-network copay

$75 out-of-network copay

Signature (HMO)

A Medicare Advantage plan that offers hospital, medical, prescription drug coverage, and more—all in one plan with a flexible benefit card to help pay for covered healthcare expenses.

Plan highlights

$1 copay for preferred generic drugs (30-day supply)

Comprehensive dental coverage for $0 ($1,000 annual benefit max)

$130/year Flex card for cost shares for Part A and Part B Medicare-covered services, cost shares for routine podiatry and routine chiropractic services, and out-of-pocket costs for dental, vision, and hearing services. Plus, you can use it for exercise equipment, activity trackers, and personal emergency response systems (PERS)

Convenient prescription drug delivery options

Routine vision and hearing exams, $200/year allowance for eyeglasses or contact lenses, and hearing aids for as low as $0

Worldwide emergency and urgent care coverage with a maximum benefit allowance

Access to more than 100,000 in-network providers

Costs

Premium

$0

Deductible

$3001

$4502

1 for Bronx, Kings, Nassau, New York, Queens, Richmond counties

2 for Orange, Rockland, Sullivan, Westchester counties

Copays/Coinsurance
Primary Care Provider Visit

$0 copay

Specialist Visit

$40 copay

Life Improvement Plan (HMO D-SNP)

Star Rating

A Medicare Advantage plan with a $0 monthly plan premium, prescription drug coverage, and as low as $0 copays. This plan is for those who are dual eligible for both Medicare and Medicaid coverage.

Plan highlights

$175/month with the OTC Plus card for over-the-counter (OTC) items, healthy foods, home utilities, personal emergency response systems (PERS), exercise equipment, activity trackers, and more*

As low as $0 copays for covered prescription medications

18 no-cost, one-way trips per year to in-network doctors for covered services

Comprehensive dental including dentures, extractions, crowns, root canals, and more for $0**

Routine vision and hearing exams, $300/year allowance for eyeglasses or contact lenses, and hearing aids for as low as $0

Costs

Premium

$0

Deductible

$0

Copays/Coinsurance

Primary Care Provider Visit

$0 copay

Specialist Visit

$0 copay

Increased Benefits Plan (HMO)

Star Rating

A Medicare Advantage plan with a $0 monthly plan premium, prescription drug coverage, and no or low copays. This plan is for those who qualify for Extra Help, also known as Low Income Subsidy (LIS), which helps to lower prescription drug costs.

If you have Extra Help, you will have a $0 monthly premium. If you do not have, or you lose, Extra Help, you will pay up to $24.20 for your monthly premium.

Plan highlights

$35/month OTC Plus card for over-the-counter (OTC) items, personal emergency response systems (PERS), exercise equipment, activity trackers, and more

Comprehensive dental coverage for $0 ($1,500 annual benefit max)

20 no-cost, one-way trips per year to in-network doctors for covered services

24/7 access to doctors by phone or video chat for $0

Routine vision and hearing exams, $250/year allowance for eyeglasses or contact lenses, and hearing aids for as low as $0

SilverSneakers® fitness program for $0

Costs

Premium

$0

Deductible

$0

Copays/Coinsurance
Primary Care Provider Visit

$0 copay

Specialist Visit

$25 copay

CompleteCare (HMO D-SNP)

Star Rating

This all-in-one Medicaid Advantage Plus (MAP) plan includes medical coverage (doctor visits), prescription drug coverage, Long Term Services and Supports, a $252/month OTC Plus card to spend on over-the-counter (OTC) items, healthy foods, home utilities, and much more.*

Plan highlights

Long-term care benefits, such as personal care aide services, adult day health center, social day center, and more

Dedicated Care Team to help you meet your care goals and live independently at home

Support for caregivers through Carallel®

$252/month OTC Plus card for over-the-counter (OTC) items, healthy foods, exercise equipment, activity trackers, home utilities, including gas, oil, electric, water, and internet service, and more*

Comprehensive dental, including dentures, crowns, root canals for $0

$0 copay for all other covered services, including free entry-level hearing aids

Costs

Premium

$0

Deductible

$0

Copays/Coinsurance
Primary Care Provider Visit

$0 copay

Specialist Visit

$0 copay

65 Plus Plan (HMO)

Star Rating

This Medicare Advantage plan offers additional benefits on top of Original Medicare, such as dental, vision, hearing, and acupuncture. It is designed for people who don’t qualify for programs that help pay Medicare costs, like Extra Help or Medicaid.

Plan highlights

$25/month OTC Plus card that you can use for over-the-counter (OTC) items, personal emergency response systems (PERS), exercise equipment, activity trackers, and more.

Comprehensive dental coverage for $0 ($1,250 annual benefit max)

8 no-cost, non-emergent one-way trips per year to in-network doctors for covered services

24/7 access to doctors by phone or video chat for $0

Routine vision and hearing exams, $150/year allowance for eyeglasses or contact lenses, and hearing aids for as low as $0

SilverSneakers® fitness program for $0

Costs

Premium

$0

Deductible

$0

Copays/Coinsurance
Primary Care Provider Visit

$0 copay

Specialist Visit

$35 copay

Connection Plan (HMO D-SNP)

Star Rating

A Medicare Advantage Dual-Eligible Special Needs (HMO D-SNP) plan that works directly with your existing Medicaid coverage and offers members the benefits of both Original Medicare and Medicaid. Plus extra benefits, such as prescription medications, OTC Plus card, SilverSneakers® fitness program, 24/7 access to care via phone or video chat, and more. You also don’t need referrals to see in-network specialists.

Plan highlights

$55/month with the OTC Plus card for over-the-counter (OTC) items, healthy foods, home utilities, personal emergency response systems (PERS), exercise equipment, activity trackers, and more.*

Copays as low as $0 for covered prescription drugs

18 no-cost, one-way trips per year to in-network doctors for covered services

Comprehensive dental, including dentures, extractions, crowns, root canals, and more for $0**

Routine vision and hearing exams, $250/year allowance for eyeglasses or contact lenses, and hearing aids for as low as $0

Costs

Premium

$0

Deductible

$0

Copays/Coinsurance
Primary Care Provider Visit

$0 copay

Specialist Visit

$0 copay

*Healthy foods and home utilities are special supplemental benefits for members enrolled in a Healthfirst dual-eligible special needs plan. To be eligible, you must have a chronic condition such as cardiovascular disorder, disabling mental health condition, diabetes, lung disorders, obesity, or another eligible condition not listed. Benefit eligibility is not based on your chronic condition alone.

**Dental services must be medically necessary; limitations and exclusions apply.

Benefits and features listed are for 2026. Coverage is provided by Healthfirst Health Plan, Inc., Healthfirst PHSP, Inc., and/or Healthfirst Insurance Company, Inc. (together, “Healthfirst”). Healthfirst Medicare Plan has HMO and PPO plans with a Medicare contract. Our SNPs also have contracts with the NY State Medicaid program. Enrollment in Healthfirst Medicare Plan depends on contract renewal. Plans contain exclusions and limitations. Benefits vary by plan.

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)。

OTC items are subject to the plan’s list of eligible items and the plan’s participating network of retail, online, and utility providers. Home utilities include gas, oil, electric, water, and internet service.

Plans vary by service area. Out-of-network/non-contracted providers are under no obligation to treat Healthfirst Medicare Plan members, except in emergency situations. Out-of-network healthcare services may have higher costs. Please call Member Services or see your Evidence of Coverage for more information, including the cost-sharing that applies to out-of-network services.

You must continue to pay your Medicare Part B premium. This information is not a complete description of benefits. Contact the plan for more information. Benefits, premiums, and/or copayments/coinsurance may change each year. The formulary, pharmacy network, and/or provider network may change at any time. You will receive notice when necessary.

SilverSneakers is a registered trademark of Tivity Health, Inc. © 2025 Tivity Health, Inc. All rights reserved.

DentaQuest is contracted with Healthfirst to provide dental benefits to its members.

EyeMed is contracted with Healthfirst to provide vision benefits to its members.

No out-of-pocket costs for entry-level hearing aids. Eyewear allowance can only be used at participating retailers.

A sales person will be present with information and applications. For accommodations of persons with special needs at sales meetings, call 1-888-260-1010 (TTY 1-888-542-3821).

The number of provider locations is current as of August 4, 2025, and subject to change due to periodic changes in our network.

Healthfirst has 4.5-star-rated (out of five stars) Medicare Advantage plans in 2025. Every year, Medicare evaluates plans based on a 5-star rating system.

Apple® compatibility: Requires iOS 13.0 or later. Compatible with iPhone®, iPad®, and iPod touch®. Apple and the Apple logo® are registered trademarks of Apple Inc. Android™ compatibility: Requires Android 8.0 Oreo™ or later. Compatible with phones for Android. Android, Google Play, and the Google Play logo are trademarks of Google LLC.

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