Our Medicare Advantage plans (HMO & PPO) offer you more benefits than Original Medicare. And our 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 $252/month ($3,024/year) for over-the-counter items, healthy foods, home utilities, and more!*
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 medications
Flexibility to go out of network and visit any doctor or hospital in the U.S. that accepts Medicare for medical care with our PPO plan
Just answer a few quick questions below. Or skip the questions and see all plans.
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.
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.
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.
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.
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.
$40 copay for specialist visits
$1 copay for preferred generic drugs (30-day supply)
Plus you'll get:
Comprehensive dental coverage for $0 ($1,000 annual benefit max)
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
for Bronx, Kings, Nassau, New York, Queens, Richmond Counties
for Orange, Rockland, Sullivan, Westchester Counties
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. Members will also get access to:
$40 copay for in-network specialist visits / $75 out-of-network
$1 copay for preferred generic drugs (30-day supply)
Plus you'll get:
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
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.*
We've been helping New Yorkers of all ages and incomes get access to affordable, quality health insurance for more than 30 years. And we can help you, too. Healthfirst is one of New York's largest not-for-profit health insurers, serving two million members with health plans that fit every stage of life, including Medicare Advantage plans. Our service area includes New York City, and Nassau, Westchester, Orange, Rockland, and Sullivan counties.
Members of some plans will receive an OTC Plus card with a monthly allowance to purchase approved over-the-counter (OTC) non-prescription medications and health-related items at participating pharmacies and retailers. In addition, they can buy exercise equipment and activity trackers. Eligible members can also buy healthy foods and pay for home utilities.*
Call our Medicare specialists to learn how you can save with our plans. We'll help you:
Talk to one of our Medicare experts to understand your plan options and benefits. Join us.
*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.
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