Healthfirst Medicare Advantage plans provide all the benefits and services that Original Medicare does, plus a whole lot more—for less. We offer a variety of plans to meet your needs, with benefits such as prescription drug coverage; over-the-counter allowance; dental, hearing, and vision benefits; the SilverSneakers® fitness program; 24/7 access to care via phone or video chat; and the option to go out of network for care. With Healthfirst Medicare Advantage plans, you can enjoy enhanced coverage and added convenience for your healthcare needs.
Healthfirst Long-Term Care plans provide health benefits that help you (or your loved one) remain at home and independent for as long as possible. We offer plans that combine hospital, medical, and prescription drug coverage with long-term care benefits, as well as a stand-alone managed long-term care plan option. With Healthfirst Long-Term Care plans, you’ll have access to a care management team, which includes a primary care manager and other support staff who will help you develop your own personal care plan centered around your care goals and coordinate the services you need. Together, they will help you (or your loved one) with your day-to-day needs and coordinate care with you, your doctor, and your family.
Healthfirst offers a variety of plans designed to meet your unique needs. See below for plan details or call us for more information.
The amount you must pay in covered expenses each year before your plan or program pays anything for certain covered services. The deductible may not apply to all services. There may be different deductibles for different services (e.g., medical vs. pharmacy). Not all plans require deductibles. This is separate from a monthly premium payment. Example: If your deductible is $500, you need to spend $500 for covered healthcare services within one year before your plan or program will start paying for your health services. Your deductible resets once every year.
A federal program to help people with limited income and resources pay Medicare prescription drug program costs like premiums, deductibles, and coinsurance.
The amount you must pay monthly, quarterly, or twice a year to be covered by a health insurance plan or program.
SilverSneakers is a Medicare fitness program that uses exercise and social opportunities to promote well-being among seniors.
This Medicare Advantage Prescription Drug plan is for those who want the flexibility to go out of network and visit any doctor and hospital in the U.S. that accepts Medicare. In addition to a $0 monthly plan premium, prescription drug coverage, and copays as low as $0, it offers dental and vision benefits with no additional premium and a Flex card that can be used for dental, vision, and hearing out-of-pocket costs.
This Medicare Advantage Prescription Drug plan is for those who want the flexibility to pick a benefit that best suits their needs. It is a $0 premium plan that provides a choice of supplemental benefits (OTC card or transportation), prescription drug coverage, and low or no copays, with more than what Original Medicare offers.
This Medicare Advantage Prescription Drug plan is for those who qualify for full Extra Help (also known as Low Income Subsidy (LIS), which helps to lower prescription drug costs. It offers a $0 monthly plan premium,* prescription drug coverage, an OTC Plus card, and low or no copays.
*If you qualify for full Extra Help, your monthly premium will be $0. If you lose full Extra Help, your monthly premium may be $39.20.
This Medicare Advantage Prescription Drug plan is for those who are eligible for Medicare and who are also receiving full Medicaid benefits or cost-sharing assistance from Medicaid. It offers a $0 monthly plan premium, $0 for all covered prescription drugs, an OTC Plus card, and low or no copays.
This Medicare Advantage Prescription Drug plan is for those who are newly eligible for Medicare and are current members of a Healthfirst Medicaid plan. It offers a $0 monthly plan premium, OTC Plus card, prescription drug coverage, and low or no copays.
Learn about Coverage Decisions, Appeals, and Complaints for Medicare Plan Members
You also have the option to submit complaints/grievances directly through Medicare.gov
We have plans for all ages, needs, and income levels. To see which Healthfirst plans are right for you, please use our plan recommendation tool or contact us.
Healthfirst is a not-for-profit community organization sponsored by some of the most prestigious and nationally recognized hospitals and medical centers in New York. With more than a million members and growing, Healthfirst has been serving communities in New York City for more than 30 years. With access to thousands of doctors and specialists, you’re sure to find the service you need nearby. Each of our community offices is fully staffed with representatives who can answer questions—in many different languages—about our health insurance plans and programs, whether you’re a member or not.
The easiest way to enroll in a Healthfirst plan is to contact us. Our sales reps can guide you to the best plan for you and ease the enrollment process.
To learn more about our Healthfirst plans or find the one that’s right for you, use our plan recommendation tool.
We’re happy to answer your questions. Our service centers hours are:
Request a call and our sales team will call 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.
100 Church Street, New York, NY 10007
If you receive Medicaid and want to know whether you are eligible for a managed long-term care plan, you can call the New York Independent Assessor (NYIA) formerly Conflict-Free Evaluation Enrollment (CFEEC) at 1-855-222-8350, Monday to Friday, 8:30am–8pm, and Saturday, 10am–6pm, to schedule their initial assessment.
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.
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.
This information is not a complete description of benefits. Contact the plan for more information. Benefits, premiums, and/or copayments/coinsurance may change on January 1 of each year.
Dental services must be medically necessary; limitations and exclusions apply.
OTC items are subject to the plan’s list of eligible items and the plan’s participating network of retail, online, and utility providers.
Plans vary by service area. Out-of-network healthcare services may have higher costs. 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.
SilverSneakers is a registered trademark of Tivity Health, Inc.© 2023 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.
SilverSneakers is a registered trademark of Tivity Health, Inc. © 2023 Tivity Health, Inc. All rights reserved.
Modivcare and Medical Answering Services provide the covered transportation services under your plan.
Last update June 24, 2024 @ 9:48 am
Y0147_MKT24_67 1102-23_M
