What Healthfirst Medicare Advantage Plans are Offered in 2021?

Healthfirst is a private insurance company that offers Medicare Advantage plans in New York state.

Read on to find out more about the Medicare Advantage plans that Healthfirst offers to residents who live in certain areas of New York.

Healthfirst Medicare Advantage plan options

Healthfirst offers several types of Medicare Advantage plans. Availability will depend on where you live. Let’s go over each type of plan and what it offers.

Healthfirst HMO plans

A Health Maintenance Organization (HMO) is a common approach for Medicare Advantage plans. Under an HMO plan, you’ll usually seek care from your plan’s network of providers.

If you choose an out-of-network provider, you may have to pay more or the service may not be covered.

Healthfirst’s Medicare Advantage plans are HMO plans. They don’t require a referral from your primary care doctor if you want to see an in-network specialist.

Here’s an overview of each of Healthfirst’s HMO plans.

Coordinated Benefits Plan

This HMO plan has a $0 monthly premium but does not include prescription drug coverage. Healthfirst recommends this plan if you have other prescription drug coverage. This could be through an employer, union, or another insurance source.

The plan provides all the benefits of original Medicare (parts A and B), plus:

• annual physical exam
• around-the-clock access to Teledoc and the nurse helpline
• dental coverage
• hearing exams and hearing aids
• vision exams and eyeglasses
• SilverSneakers fitness program
• routine transportation (nonemergency)
• meal delivery service

Increased Benefits Plan

This HMO plan is for those who qualify for Extra Help, a program that helps people who have Medicare pay for prescription drugs. Benefits associated with this plan include all the coverage of the Coordinated Benefits Plan, plus:

• prescription drug coverage
• over-the-counter (OTC) allowance of $15 per month for the purchase of OTC items (approved non-prescription drugs and health-related items)
• acupuncture coverage

65 Plus Plan

This $0 monthly HMO Advantage plan is for those who would like Healthfirst coverage and aren’t enrolled in Extra Help, a Medicare savings program, or Medicaid. Aside from the basic coverage, added benefits are similar to those in the Increased Benefits Plan.

Signature HMO

This $0 monthly premium Medicare Advantage plan includes and access to a specially-trained member services team to help you with your healthcare choices. The plan provides all the benefits of the 65 Plus Plan, plus:

• Choice Extra over-the-counter (OTC) allowance of $35 per quarter in the form of a Healthfirst OTC card with your pre-funded monthly amount
• nutrition counseling of up to six sessions per year

Healthfirst Special Needs Plans

Healthfirst offers two Special Needs Plans (SNPs). These are HMO plans specifically designed for those who qualify for both Medicare and Medicaid. Here are some details about Healthfirst’s two SNP options.

Healthfirst Life Improvement Plan

Some of the plan’s major offerings include:

• prescription drug coverage
• dental
• hearing exams and hearing aids
• vision exams plus eyeglasses
• over-the-counter medication benefit of $1,740 per calendar year ($145 per month)
• SilverSneakers fitness program
• acupuncture
• routine transportation (nonemergency)
• meal delivery

Eligible service areas for this plan include those within New York City, as well as Nassau, Orange, Sullivan, and Westchester counties.

CompleteCare

Benefits associated with this plan include all of the coverage in the Healthfirst Life Improvement Plan, plus adult day healthcare and home care.

Healthfirst Part D options

Most Medicare Advantage plans through Healthfirst offer Part D coverage. But Healthfirst doesn’t offer separate Medicare Part D plans. This means your Part D coverage will be bundled into your plan instead.

Healthfirst plans that have Part D coverage include:

• Increased Benefits Plan (HMO)
• 65 Plus Plan (HMO)
• CompleteCare (HMO SNP)
• Life Improvement Plan (HMO SNP)
• Signature (HMO)

If you wish to purchase a separate prescription drug plan, you can do so from another company.

What areas offer Healthfirst Medicare Advantage plans?

Healthfirst currently offers Medicare Advantage plans only in New York state. Covered cities include New York City and those on Long Island, as well as Orange, Rockland, Sullivan, and Westchester counties.

If you’re curious whether Healthfirst offers a Medicare Advantage plan in your area, you can use Medicare’s plan finder tool.

What do Healthfirst Medicare Advantage plans cover?

Healthfirst Medicare Advantage plans offer the traditional coverage under original Medicare, plus additional services. You can refer to the specific plan’s information regarding costs for these services. Some are offered with $0 copayment.

Healthfirst plans include the following:

Preventive care and exams

Original Medicare doesn’t cover some of the medical services that you might consider essential. Healthfirst plans may offer some of them, including:

• dental
• hearing and hearing aids
• vision and eyeglasses

How much do Healthfirst Medicare Advantage plans cost?

The following are some examples of Healthfirst’s Medicare Advantage plans and their costs in different locations for 2021.

These are just some examples of available Healthfirst plans by ZIP code. You can use Medicare’s compare plan tool to find out more about each of these plans and the costs in your area.

What is Medicare Advantage (Medicare Part C)?

Medicare Advantage, or Part C, is an alternative to original Medicare (Part A and Part B) where a private insurance company contracts with Medicare to provide your health benefits.

You may prefer a Medicare Advantage plan if you’d like extra coverage for things that traditional Medicare doesn’t cover, such as prescription drug benefits or vision, dental, and other services.

Medicare Advantage plans aren’t uniform — they usually vary by company and region. This is because the plan typically contracts with providers and healthcare organizations in your area to become “in network,” which helps them offer cost savings to you.

While some Medicare Advantage plans have a monthly premium, others do not. You may still pay your Medicare Part B premium, however, depending on the Medicare Advantage plan you choose.

The takeaway

Healthfirst offers several Medicare Advantage plans to those living in certain areas of New York state. The plans largely use an HMO model and also include SNPs for those who need long-term care or are also enrolled in Medicaid.

You can visit Medicare.gov or call Medicare at 800-MEDICARE (800-633-4227) to find out more about available Medicare Advantage plans.

Read more on: medicare, healthfirst