Medicaid Managed Care

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A Medicaid plan with a $0 monthly plan premium and low or no copays for doctor visits, lab tests, hospitalization, urgent care, emergency care, maternity, dental, vision, hearing, wellness, and more. Sponsored by New York State, this plan is for qualified low-income families and individuals under 65.

Beginning April 1, 2023, all Medicaid members enrolled in Healthfirst Medicaid Managed Care will receive their prescription drugs through NYRx, the Medicaid Pharmacy Program.

Information about the transition of the pharmacy benefit from Healthfirst Medicaid Managed Care to NYRx, the Medicaid Pharmacy Program can be found here.

General information about NYRx, the Medicaid Pharmacy Program can be found here along with information for Members and Providers.

Plan Highlights:

  • No-cost annual checkups
  • Hospital, emergency room, retail health clinic, and urgent care visits
  • Maternity coverage, plus your newborn is automatically enrolled in Medicaid
  • Hearing, vision, and dental coverage
  • Transportation to and from doctor appointments for covered services**
  • Physical, occupational, and speech therapy
  • Health and wellness programs
  • NEW - Institution for Mental Disease (IMD) In Lieu of Service (ILS)
  • 24/7 access to care with telemedicine (Teladoc)*
  • 2023
Medicaid Managed Care
Covered Services
Star Ratings
Comprehensive Formulary
Search the list of drugs covered by the Medicaid NYRx pharmacy program
Eligible Age
Under 65
Eligible Service Areas
Within New York City's five boroughs (the Bronx, Brooklyn, Manhattan, Queens, and Staten Island), Long Island, and Westchester, Orange, Rockland, and Sullivan counties
Other Eligibility Requirements
Meet the Medicaid Managed Care income requirements. Not sure if you’re eligible? Find out now
Dental Cleanings
Pediatric – $0 copay
Adult - $0 copay
Vision Exams
Pediatric – $0 copay
Adult - $0 copay
Telemedicine (Teladoc)
$0 copay
Costs & Benefits
Medicaid Managed Care
Deductible (Individual)
Maximum Out-of-Pocket (Individual)
Your Annual Checkup
$0 copay
Primary Care Provider (PCP) Visit
$0 copay
Specialist Visit
$0 copay
Retail Health Clinic
$0 copay
Urgent Care
$0 copay
Emergency Room
$0 copay
$0 copay
$0 copay
Outpatient Facility
$0 copay
Inpatient Hospital Stay
$0 copay per admission

*Some copays may apply.

**ModivCare® and Medical Answering Services provide the covered transportation services under your plan.

The benefit information provided is a brief summary, not a complete description, of benefits. For more information, contact the plan.

Coverage is provided by Healthfirst Health Plan, Inc., Healthfirst PHSP, Inc., and/or Healthfirst Insurance Company, Inc. (together, “Healthfirst”). Plans contain exclusions and limitations.

Additional Benefits

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    24/7 Access to Telemedicine with Teladoc*

    Talk to a doctor any time—for a $0 copay. Connect with board-certified doctors through video chat or phone for prescriptions, help diagnosing and treating non-emergency conditions, and more. Access to dermatologists is also available.

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    See better with Healthfirst Vision Benefits

    Taking care of your eyes doesn’t just mean having clear vision. An annual eye exam can help detect a number of health risks, such as diabetes, thyroid disease, high blood pressure, and other conditions. Healthfirst has made it easy for our members to take advantage of this often overlooked preventive service by providing access to comprehensive vision care.

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    Dental Care That Keeps You Smiling

    Healthfirst believes that providing you with good dental care is important to your overall healthcare. Covered services include regular and routine dental services such as preventive dental checkups, cleanings, X-rays, fillings, and other services to check for any changes or abnormalities that may require treatment and/or follow-up care for you. You do not need a referral from your PCP to see a dentist.

Additional Benefits

  • 24/7 Access to Telemedicine with Teladoc*

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  • See better with Healthfirst Vision Benefits

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  • Dental Care That Keeps You Smiling

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Frequently Asked

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  • Who is eligible to enroll? FAQ dropdown arrow
  • Why should I choose Healthfirst? FAQ dropdown arrow
  • How can I enroll? FAQ dropdown arrow

Support When You Need It

We’re happy to answer your questions.

Learn about enrollment


Monday to Saturday, 8am–8pm

TTY English: 1-888-542-3821

TTY Español: 1-888-867-4132

Member Services


Monday to Friday, 8am—6pm

TTY English: 1-888-542-3821

TTY Español: 1-888-867-4132

Can’t talk right now?

Request a callback and we’ll get back to you within one business day.

You can also visit our Virtual Community Office to connect with a local Healthfirst representative or to find a community office near you.

You can also go to the NY State of Health’s website to view your choices, or call the NY State of Health customer service center at 1-855-355-5777.