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Healthfirst NY Medicare Advantage (Part C) Plans

New to Medicare or looking for a new Medicare Advantage plan? You've come to the right place.

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About Medicare

Medicare is health insurance for people age 65 or older. You may also get Medicare earlier if you have certain disabilities such as, End-Stage Renal Disease (ESRD) or ALS (also known as Lou Gehrig’s disease). Original Medicare (Part A and Part B) provides hospital and medical insurance. Medicare Advantage plans (Part C) offer the same benefits as Original Medicare, plus so much more.

What is the difference between Original Medicare vs. Medicare Advantage (Part C) plans?

Original Medicare covers only 80% of your healthcare expenses, and it doesn’t cover eye exams, most dental care, and other health benefits.

Most Medicare Advantage (Part C) plans offer many benefits that Original Medicare does not, including prescription drugs (Part D). See the chart below.

Original Medicare (Parts A and B) provides: Medicare Advantage HMO plans (Part C) offer benefits such as: Medicare Advantage PPO plans (Part C) offer benefits such as:
Coverage for hospitalization, doctors, skilled nursing facility, outpatient care, preventive services
Prescription drug coverage
Dental, vision, and hearing benefits, OTC Plus/OTC or Flex card allowance, 24/7 telemedicine, fitness/gym membership, nutrition counseling
Annual maximum out-of-pocket protection
Option to see any provider in the U.S. that accepts Medicare Only in medical emergencies

Your choice of Healthfirst HMO and PPO Medicare Advantage (Part C) plans

With Healthfirst, you can get the care you need with as low as $0 monthly plan premiums, 24/7 access to care, a large network of healthcare providers, and more.

Choose one of our HMO plans if you want access to care from 100,000+ provider locations.* For more flexibility—including the option to go out of network; a $725/year Flex card that you can use to pay for dental, vision, and hearing costs; and other benefits—enroll in our PPO plan.

*The number of provider locations is current as of October 31, 2023, and subject to change due to periodic changes in our network.

Enroll and get connected to Healthfirst professionals:

  • If you're eligible, our Care Management Team can help coordinate care with your doctor and specialists to manage any chronic conditions.
  • Our Pharmacy Team can help you get the prescriptions you need and remind you to refill on time.
  • Long-Term Care Specialists will help you get the assistance you need to live as independently as possible in your home.
  • Plus, many other Healthfirst teams working for your health.

When can you enroll in a Medicare Advantage (Part C) Plan?

If you are new to Medicare, your birthday month will determine your initial enrollment period for Original Medicare. Plan to enroll by the end of your birthday month to avoid a gap in coverage.

Here's when you may switch from one Medicare Advantage plan or Medicare Part D plan to another, switch from Original Medicare to a Medicare Advantage plan or vice versa, or enroll in a Medicare Part D plan or a Medicare Advantage plan for the first time.

During this period, you may switch from one Medicare Advantage plan to another, or switch from your Medicare Advantage plan and return to Original Medicare with a stand-alone Part D plan.

Allows you to change your current Medicare plan or enroll in a new plan once a month (whenever you experience a Qualifying Life Event).

Your monthly premium for Part B (Medical Insurance) will go up―by 10% for each year you wait to enroll. This penalty lasts for as long as you have Medicare. There may also be penalties for enrolling late in a Medicare prescription drug plan (Part D). To avoid these penalties, don’t wait to sign up for Part D or a Medicare Advantage plan with Part D coverage.

Learn More About Medicare

If you’d like to learn more about Medicare in general, we’ve made it easier for you.

Visit Medicare Learning Center
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Ready to enroll?

Learn about your Healthfirst plan options

Still have questions? Talk to one of our Medicare experts.

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1-855-725-3341 TTY: 1-888-542-3821
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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.

Healthfirst complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex.

ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 1-866-305-0408 (TTY 1-888-867-4132). 注意：如果您使用繁體中文，您可以免費獲得語言援助服 務。請致電1-866-305-0408 (TTY 1-888-542-3821).

Plans above reflect amounts after Extra Help or Medicaid secondary coverage has been applied.

Out-of-network healthcare services may have higher costs. Plans vary by service area. Out-of-network/non-contracted providers are under no obligation to treat plan members, except in emergency situations. Please call our customer service number 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.

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

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

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

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