Our Medicare Advantage plans (HMO & PPO) offer you more benefits than Original Medicare. And our new PPO plan lets you see out-of-network healthcare providers.
Healthfirst Medicare Advantage plans give you more of the benefits and features you want, such as:
OTC Plus card of up to $575/quarter for over-the-counter items, healthy foods, and more. Now including most home utilities!
As low as $0 copays for dental coverage, which includes root canals, extractions, dentures, crowns, and more
As low as $0 monthly plan premiums, $0 deductible, and as low as $0 copays for prescription drugs
Flexibility to go out of network and visit any doctor or hospital in the U.S. that accepts Medicare for medical care
Just answer a few quick questions below. Or skip the questions and see all plans.
Healthfirst 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. Members will also get access to:
$35 copay for in-network specialist visits / $60 out-of-network
$0 copay for preferred generic drugs
Plus you'll get:
Comprehensive dental
Convenient prescription drug delivery options
Routine vision and hearing exams, plus eyeglasses and hearing aids
Worldwide emergency and urgent care coverage with a maximum benefit allowance
Medicare Advantage plan with enhanced benefits and greater flexibility for those who want an added level of choice.
Members can select one of the Healthfirst Signature Choice Extras benefits each year:
Plus, access care at more than 100,000 in-network provider locations.
$30 copay for specialist visits
$0 copay for preferred generic drugs
Plus you'll get:
Comprehensive dental coverage for $0
Convenient prescription drug delivery options
Routine vision and hearing exams, plus eyeglasses and hearing aids
Worldwide emergency and urgent care coverage with a maximum benefit allowance
A Medicare Advantage plan with a $0 monthly plan premium, prescription drug coverage, and no copays. This plan is for those who are dual eligible for both Medicare and Medicaid coverage.
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 full Extra Help, also known as Low Income Subsidy (LIS), which helps to lower prescription drug costs.
‡If you have Extra Help (also known as Low Income Subsidy), you will pay a $0 monthly premium. If you do not have or you lose Extra Help, you will pay up to $36.10 for your monthly premium. If you lose full Extra Help, your monthly premium will change and your annual deductible may be $590. However, all members with full Extra Help will have $0 monthly premiums and a $0 annual deductible.
**For Members with full Extra help; members without Extra Help can use their OTC Plus card for OTC, fitness equipment, activity trackers, and personal emergency response systems.
This all-in one Medicaid Advantage Plus (MAP) plan includes medical coverage (doctor visits), prescription drug coverage, Long Term Services and Supports, a $280-a-month OTC Plus card to spend on over-the-counter (OTC) items, healthy foods to home utilities, and much more.*
A Medicare Advantage plan with a $0 monthly plan premium, prescription drug coverage, and no or low copays. This plan is for those who may qualify for additional financial assistance (Extra Help, Medicare Savings Programs, or Medicaid) providing help with drug costs, deductibles, and copays.
We've been helping New Yorkers of all ages and incomes get access to affordable, quality health insurance for 30 years. And we can help you, too. Healthfirst has the largest Medicare Advantage membership in the NY metropolitan area, including New York City, Nassau, Westchester, and the Lower Hudson Valley.4
4Based on June 2022 CMS Medicare Advantage/Part D Contract and Enrollment data, excludes EGHP and ISNP.
Depending on your plan, you will receive an OTC Plus/OTC card with a maximum limit for purchasing approved over-the-counter (OTC) non-prescription drugs and health-related items at participating pharmacies and retailers. In the case of CompleteCare you can also buy home fitness equipment and activity trackers. For those CompleteCare members who are eligible you can also buy healthy foods and pay home utility bill(s)*. Life Improvement Plan members can also use their OTC Plus card for personal emergency response systems (PERS). In the case of Signature (PPO), you receive a $725/year Flex card that can be used for dental, vision, and hearing out-of-pocket costs.
It’s now easier than ever to qualify for help paying your Medicare expenses. New York State expanded the Medicare Savings Program (MSP) by raising the Federal Poverty Level (FPL) eligibility requirement. That means Medicare members with higher incomes can now qualify. MSP helps pay for your Medicare premiums and lower your drug plan costs. Depending on your income, the MSP may also pay for other cost-sharing expenses—with an average savings of up to $7,000/year!
Coverage is provided by Healthfirst Health Plan, Inc. or Healthfirst Insurance Company, Inc. (“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.
Plans above reflect amounts after Extra Help or Medicaid secondary coverage has been applied.
*Healthy foods/groceries and home utilities are special supplemental benefits. To be eligible for these benefits, you must have one of the following chronic conditions: cardiovascular disorder, disabling mental health condition, diabetes, lung disorders, or obesity. There are other eligible conditions not listed. Your chronic condition alone cannot guarantee eligibility for these benefits. All applicable eligibility requirements must be met before the benefits are provided.
OTC items are subject to the plan’s list of eligible items and the plan’s participating network of retail, online, and utility providers. Balances expire upon disenrollment. Home utilities include gas, oil, electric, water, and internet service.
Dental services must be medically necessary; limitations and exclusions apply.
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.
SilverSneakers is a registered trademark of Tivity Health, Inc. (c) 2023 Tivity Health, Inc. All rights reserved.
EyeMed is contracted with Healthfirst to provide vision benefits to its members.
Healthfirst has four-star rated (out of five stars) Medicare Advantage plans in 2022. Every year, Medicare evaluates plans based on a 5-star rating system.
Healthfirst complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex.
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