Medicare Brokers | Healthfirst

Medicare Brokers

We want to reassure our broker community, as we have reassured our members and providers, that Healthfirst has robust business continuity plans in place to ensure our members continue to receive uninterrupted access to the highest-quality care. We are fully operational.

As New York’s largest not-for-profit health insurer, we understand that our members are counting on us to help them access care and get their Coronavirus: Type COVID-19 questions answered. We’re using new channels to keep our lines of communication open.

To ensure our members have the latest information on coronavirus (COVID-19), we have equipped our Member Services team with the most up-to-date information on benefit services to answer members’ questions. Our call center is fully staffed and successfully addressing increased call volumes.

Please note: the additional detail below is specifically for our Medicare Advantage plan members. Should you have any questions about a different type of Healthfirst plan, please reference additional information at healthfirst.org/coronavirus-covid-19/. Continue to check this page, as it will be updated as new information becomes available.

Social Distancing

We strongly encourage the practice of “social distancing” following the guidance provided by the medical community. The safety and well-being of our brokers, members, and staff are our chief priorities. Please leverage all resources available to you which assist you and your clients in maintaining “social distance.” By conducting your business as remotely as possible, you can help stop the spread of coronavirus (COVID-19).

Cost Sharing

Healthfirst is waiving copays for all diagnostic testing and evaluations related to coronavirus (COVID-19). This means that if a member’s PCP or in-network provider orders a coronavirus (COVID-19) test, Healthfirst will cover the cost for the test and the in-network provider visit related to the coronavirus (COVID-19) evaluation. Our members will not be subject to any cost sharing for the test or the in-network provider visit.

Teladoc

Teladoc (telehealth) service is available to Healthfirst Medicare Advantage plan members and is covered for coronavirus (COVID-19)-related inquiries. If our members think they may be infected, Teladoc doctors can answer questions about the disease, evaluate their risk, and advise them on next steps. The Teladoc clinical team is trained on the latest protocols for local and national notification, testing, and management of people under investigation for the coronavirus (COVID-19). Members may call Teladoc at 1-800-Teladoc (1-800-835-2362) or visit member.teladoc.com/healthfirst.

Pharmacy

At this time, Healthfirst Medicare Advantage plan members may get a one-time refill for a 90-day supply of chronic medication from any in-network pharmacy, including the ones listed below (while the state of emergency is in effect in New York).

• Includes diabetic medication
• Excludes controlled substances, injectables, and intravenous infusions




Pharmacy Name Features Process
• Offers same-day free delivery

• Drivers are Medly employees

• Staff speaks more than 10 languages

To transfer prescriptions, members can:

• Complete form on website: healthfirst.medlypharmacy.com OR

• Call or text 1-800-620-2561, OR

• Email request to healthfirst@medlypharmacy.com OR

• Ask their doctor to send a prescription to Medly Pharmacy

• Offers same-day delivery within service area

• Drivers are Capsule employees

• Staff speaks more than 10 languages

To transfer prescriptions, members can:

• Visit capsulecares.com and fill out form, OR

• Call or text 1-212-675-3900, OR

• Ask their doctor to send a prescription to Capsule Pharmacy

• Delivers pill packs

• Questions, call (877) 355-7225

To transfer prescriptions, members can:

• Visit exactcarepharmacy.com and fill out form, OR

• Call 1-844-287-1609

Offers free deliveries at select locations To transfer prescriptions, members can:

• Ask their doctor to send a prescription to nearest CVS pharmacy location, OR

• Call nearest CVS location and give pharmacy and prescription information

Walgreens Retail Pharmacies offer free deliveries
(Medicare only)
To transfer prescriptions, members can:

• Ask their doctor to send a prescription to nearest Walgreens pharmacy location, OR

• Call nearest Walgreens location and give pharmacy and prescription information



Over-the-Counter (OTC)

Healthfirst Life Improvement Plan (HMO SNP) members may order covered OTC items online or by phone for delivery to their home. Members can expect to receive their items within three to seven business days after an order is placed, unless a change must be made to the order for any reason. Below are the ways members can order OTC products for delivery:

  • Phone: Members can call 1-833-SHOP-OTC (1-833-746-7682) (TTY 711), Monday to Friday, 8am–8pm EST. Language support services are available if needed.
  • Online: Members can visit NationsOTC.com.
    • Enter their OTC card number to log in.
    • Update their account profile with shipping address details.
    • To place an order, member selects products and completes the checkout process.
  • Request an OTC catalog be mailed to their home address by calling 1-833-SHOP-OTC (1-833-746-7682) (TTY 711), Monday to Friday, 8am–8pm. To order a catalog item, member completes and sends in the mail order form included in the catalog. The catalog can also be viewed here: nationscdn.azureedge.net/otc-container/pdf/Medicare-catalog.pdf.

Note: Home delivery is available for OTC items only; grocery items are not eligible for home delivery. If members have concerns about their OTC funds, please advise them to call Member Services at 1-888-260-1010 (TTY English 1-888-542-3821; TTY Spanish 1-888-867-4132), 7 days a week, 8am–8pm.

We are proactively monitoring Centers for Medicare and Medicaid Services (CMS) guidance, and we’ll keep the broker community posted if there are any changes. We will also continue to communicate with you regarding any new developments as they relate to Healthfirst’s business practices in handling coronavirus (COVID-19). Feel free to contact your Healthfirst account executive, or to call Broker Services at 1-855-456-3668, Monday to Friday, 9am–5pm, if you have any questions or concerns about Healthfirst’s coronavirus (COVID-19) coverage.

Thank you for working with Healthfirst!