New to Medicare or looking for a new Medicare Advantage plan? You've come to the right place.
Medicare is health insurance for people age 65 or older. You may also get Medicare earlier if you have certain disabilities (e.g., End-Stage Renal Disease (ESRD) or ALS (also known as Lou Gehrig’s disease))*. Original Medicare (Part A and Part B) provides hospital and medical insurance. Medicare Advantage plans (Part C) offer the same benefits as Original Medicare, plus so much more.
Original Medicare only covers 80% of your healthcare expenses, and it doesn’t cover eye exams, most dental care, routine exams, and other health benefits.
Most Medicare Advantage plans offer many benefits that Original Medicare does not, including prescription drugs (Part D). See the chart below.
|criteria||Original Medicare (Parts A & B) provides:||Medicare Advantage HMO plans (Part C) offer benefits such as:||Medicare Advantage PPO plans (Part C) offer benefits such as:|
|Coverage for hospitalization, doctors, skilled nursing facility, outpatient care, preventive services|
|Prescription drug coverage|
|Dental, vision, and hearing benefits, 24/7 telemedicine, fitness/gym membership, nutritional counseling|
|Annual maximum out-of-pocket protection|
|Option to see any provider in the U.S. that accepts Medicare||Only in medical emergencies|
With Healthfirst, you can get the care you need when you need it with as low as $0 monthly plan premiums, 24/7 access to care, a large network of healthcare providers, and more.Choose one of our HMO plans if you want access to care from 100,000+ provider locations.*
For more flexibility—including the option to go out of network and visit any healthcare provider in the U.S. that accepts Medicare; a $700/year Flex card that you can use to pay for dental, vision, and hearing out-of-pocket costs; and other benefits—enroll in our new PPO plan.
Here's when you may switch from one Medicare Advantage plan or Medicare Part D plan to another, switch from Original Medicare to a Medicare Advantage plan or vice versa, or enroll in a Medicare Part D plan or a Medicare Advantage plan for the first time.
During this period, you may switch from one Medicare Advantage plan to another, or switch from your Medicare Advantage plan and return to Original Medicare with a stand-alone Part D plan.
Certain circumstances (such as a move to a new area) may allow you to switch plans during this period.
If you are new to Medicare, your birthday month will determine your initial enrollment period. Plan to enroll by the end of your birthday month or you may have a gap in coverage.
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.
Some dental services must be medically necessary to be covered; 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. Balances expire upon disenrollment.
No out-of-pocket costs for entry-level hearing aids. Eyewear allowance can be used at participating retailers.
Out-of-network healthcare services may have higher costs.
Healthfirst CompleteCare will cover Non-Emergency Medicaid-covered transportation provided that it is included as a Managed Long Term Care benefit by the New York State Department of Health.
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.
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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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