Healthfirst NY Medicare Advantage Plans

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.

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More Benefits. More Savings. More Value.

Healthfirst Medicare Advantage plans give you more of the benefits and features you want, such as:

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OTC Plus card of up to $525/quarter for over-the-counter items, healthy foods, and more. Now including most home utilities!

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As low as $0 copays for dental coverage, which includes root canals, extractions, dentures, crowns, and more

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As low as $0 monthly plan premiums, $0 deductible, and as low as $0 copays for prescription drugs

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Flexibility to go out of network and visit any doctor or hospital in the U.S. that accepts Medicare for medical care

See which Healthfirst plan may be right for you

Just answer a few quick questions below. Or skip the questions and see all plans.

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First, enter your ZIP code
Great! We offer quality plan options in your area.
The zip code you entered is currently outside of our service area.
Do you have Medicaid?
Do you qualify for Extra Help or the Medicare Savings Program?
Do you want or need out-of-network coverage?
Great news! Our Signature (HMO) plan may be right for you.
Great news! Our Signature (PPO) plan may be right for you.
Great news! Here are two plans that may be right for you.
Signature (PPO)

Healthfirst Medicare Advantage plan for those that 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:

  • $700/year Flex card to use on dental, vision, and hearing out-of-pocket costs.
  • A broad network of more than 100,000 participating providers, plus the option to go out of network.
Signature (HMO)

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:

  • $70/quarterly over-the-counter (OTC) card, or
  • 25 no-cost, one-way trips to in-network doctors for covered services
Great news! Our Increased Benefits Plan (HMO) plan may be right for you.
Great news! Here are two plans that may be right for you.
You may qualify for one of these two plans depending on your income status; contact us for more details.
Life Improvement Plan (HMO D-SNP)

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.

Increased Benefits Plan (HMO)

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 lose full Extra Help, your monthly premium will change and your annual deductible may be $545. However, all members with full Extra Help will have $0 monthly premiums and a $0 annual deductible.

Do you need or currently get assistance at home?
Great news! Our Life Improvement (HMO D-SNP) plan may be right for you.
Great news! Our CompleteCare (HMO D-SNP) plan may be right for you.
No plans found matching these criteria.
Signature (PPO)

Healthfirst Medicare Advantage plan for those that 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:

  • $700/year Flex card to use on dental, vision, and hearing out-of-pocket costs.
  • A broad network of more than 100,000 participating providers, plus the option to go out of network.
View plan highlights
View full plan details
Is my provider in-network?
Are my drugs covered?
Start enrollment
Benefits
  • $0 copay for primary care doctor visits
  • $40 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 no maximum benefit allowance

Premium
$0
Deductible
$0
Signature (HMO)

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:

  • $70/quarterly over-the-counter (OTC) card, or
  • 25 no-cost, one-way trips to in-network doctors for covered services

Plus, access care at more than 100,000 in-network provider locations.

View plan highlights
View full plan details
Is my provider in-network?
Are my drugs covered?
Start enrollment
Benefits
  • $0 copay for primary care doctor visits
  • $35 copay for specialist visits

  • $0 copay for preferred generic drugs

Plus you'll get:

  • Comprehensive dental coverage

  • Convenient prescription drug delivery options

  • Routine vision and hearing exams, plus eyeglasses and hearing aids

  • Worldwide emergency and urgent care coverage with no maximum benefit allowance

Premium
$0
Deductible
$0
Life Improvement Plan (HMO D-SNP)

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.

View plan highlights
View full plan details
Is my provider in-network?
Are my drugs covered?
Benefits
  • $0 copays for primary care doctor and specialist visits
  • $525/quarter with the 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
  • $0 deductible and copays for all covered prescription drugs
  • Comprehensive dental including dentures, extractions, crowns, root canals, and more for $0
  • Routine vision and hearing exams, plus $350 allowance every year for 1 pair of eyeglasses or contact lenses and hearing aids for as low as $0
Star Ratings
Premium
$0
Deductible
$0
Increased Benefits Plan (HMO)

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 lose full Extra Help, your monthly premium will change and your annual deductible may be $545. However, all members with full Extra Help will have $0 monthly premiums and a $0 annual deductible.

View plan highlights
View full plan details
Is my provider in-network?
Are my drugs covered?
Start enrollment
Benefits
  • $0 copay for primary care doctor visits
  • $20 copay for specialist visits
  • $100/quarter OTC Plus card for over-the-counter (OTC) items, healthy foods, and home utilities including gas, electric, oil, water, and internet service**
  • Comprehensive dental including dentures, extractions, crowns, root canals, and more for $0
  • No-cost transportation to doctors
  • 24/7 access to doctors by phone or video chat for $0
  • Routine vision and hearing exams, plus $200 allowance every year for eyeglasses or contact lenses and hearing aids for as low as $0
  • SilverSneakers® fitness program for $0

    **For members with full Extra Help; members without Extra Help can use their OTC Plus card for OTC and health-related items only.

    Star Ratings
    Premium
    $0*
    Deductible
    $0
    CompleteCare (HMO D-SNP)

    This all-in-one Medicaid Advantage Plus plan includes both long-term care services and health coverage. So members are covered for in-home care, PLUS doctor visits, prescription drug coverage, a $250-a-month OTC Plus card to spend on healthy foods and home utilities, and much more.

    View plan highlights
    View full plan details
    Is my provider in-network?
    Are my drugs covered?
    Benefits
    • Long-term care benefits, such as home health aide services, adult day health center or social day center, and more
    • Dedicated Care Team to help you meet your care goals and live independently at home
    • $0 copay for primary care doctor visits
    • $0 copay for specialist visits
    • $250/month with the 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
    Star Ratings
    Premium
    $0
    Deductible
    $0

    Did you know?

    Why Healthfirst

    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.*
    *Based on June 2022 CMS Medicare Advantage/Part D Contract and Enrollment data, excludes EGHP and ISNP.

    Who Qualifies for OTC

    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 purchase healthy foods, home utilities, exercise equipment, and activity trackers. 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 $700/year Flex card that can be used for dental, vision, and hearing out-of-pocket costs.

    Updates to Medicare Savings Program

    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 $7,400/year!

    Need more information?

    Learn about Medicare basics

    If you’re ready to enroll, take the next step by contacting us.

    Give us a call!

    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.

    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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