Friday, May 10, 2024

Is Healthfirst Medicaid Or Medicare

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Please Click The Link Above And Call Healthfirst To Access Your Online Payment Account

Healthfirst: Medicare Advantage TV Commercial

Employers:1-855-949-3668Monday to Friday, 9 am-5 pm

We suggest you issue a monthly scheduled payment directly from your Bank, most larger banks have that service for free.

It is better to set up a monthly recurring payment online, . That way, you can track all your expenses from one place.

Healthfirst Insurance CompanyPhiladelphia, PA 19101-3831

Healthfirst Is Not Suitable For Upstate Ny & Maybe Suffolk County Residents

Healthfirst network is limited to NY downstate including the 5 Boroughs plus and Nassau County.

Healthfirst partners with Northwell, aka NSLIJ or CareConnect, to work in Nassau County.

Healthfirst is recognized as one of the best value insurance providers for Nassau County Residents. Click here to check if your hospital/doctors are in-network. This is very important as all of HealthFirst insurance plans are EPO, therefore, there are no out-of- network coverage.

In Suffolk county, hospital/doctor networks are only limited to the 5 hospitals in Suffolk County.

The 5 in-network hospitals of NSLIJ/Northwell are :

If HealthFirst added more Suffolk doctors and hospital networks in the future, we will surely update it here.

The biggest missing piece in Suffolk County is the Stoney Brook Medicine group.

So, if your doctor is within that group, please dont consider HealthFirst unless you are willing to switch doctors.

Now that the uglier part is out of the way, lets see if HealthFirst is right for you.

/7 Access To Telemedicine With Teladoc*

Talk to a doctor any timefor a $0 copay. Visit with board-certified doctors through video chat or phone for prescriptions, treatment of non-emergency health issues, and more. Access to dermatologists is also available.

*Telemedicine isnt a replacement for your Primary Care Provider . Your PCP should always be your first choice for care and for routine visits.

Don’t Miss: When Is Open Enrollment For Medicare

Website: Wwwhealthfirstorg Nys Medicaid Prior Authorization


Plan Name: Healthfirst Plan Phone No.: 1-877-433-7643 Plan Fax No.: 1-866-848-5088 Website: NYS MedicaidPrior Authorization Request Form for Prescriptions Rationale for Exception Request or Prior Authorization All information must be complete and legible Patient Information First Name: Last Name: MI: Male Female

You Can Disenroll Or Change Coverage During Applicable Enrollment Periods

Scrum Master Job Available

Not sure if you should stay with your current coverage?Give us a call and well help you figure out the best Medicare option to fit your needs.

Switching between Medicare Advantage Plans

If you enroll in a new Medicare Advantage plan, youll be automatically disenrolled from your current one.

If you receive financial assistance from the government

You dont need to wait for enrollment periods to disenroll from your plan.* You may disenroll by sending a signed and dated disenrollment request to Healthfirst Medicare plan in writing or by enrolling in another Medicare Advantage plan or Prescription Drug plan.

In the event that you did not mean to disenroll from Healthfirst Medicare Plan, you have the right and responsibility to ask us to cancel your disenrollment. However, you must notify us before the last day of the month you are enrolled in our plan. The effective date is the end of the month in which you made the completed request. *You have the chance to disenroll once every three months during the first nine months of the year.

Switching back to Original Medicare.

You may disenroll from our plan and return to Original Medicare by asking us to disenroll you. We will send you written confirmation of your disenrollment that will be effective January 1 of the following year or at the end of the month in which you completed a request.

Mail or fax a coverage change notice to:

  • Healthfirst Member Services

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Already Covered Through Work

If you have health coverage through your current employer or your spouses current employer, you may be able to delay getting Original Medicare, then sign up later during a Special Enrollment Period without a penalty. In general, it’s best to check with your employer about your options before your 65th birthday.

Accepted Plans At Newyork

Find accepted health plans listed below. While every effort is made to keep this list current, changes to insurance products do occur frequently. Always check with your insurance company to make sure that your care will be covered. If you don’t see your insurance company on this list, please contact your insurance representative.

  • 1199 National Benefit Fund
  • Affinity Health Plan,Essential Plan 1 and 2
  • Affinity Health Plan,Essential Plan 3 and 4
  • Affinity Health Plan,Medicaid and HARP
  • Agewell
  • Allied Benefit Systems ,Commercial
  • AmeriBen
  • American Postal Workers Union
  • American Postal Workers Union , Commercial
  • Amerigroup
  • Assurant Health ,Commercial
  • Beech Street
  • Blue Cross Blue Shield, Blue Card Plans
  • Boon-Chapman
  • Chesterfield Resources ,Commercial
  • Christian Brothers
  • Christian Brothers ,Commercial
  • Cigna
  • Continental Benefits ,Commercial
  • Coventry Health Care/First Health Network
  • Coventry Health Care/First Health Network, PPO
  • Devon Health Services
  • Devon Health Services, Inc., PPO
  • EmblemHealth-GHI
  • EmblemHealth-GHI , Brooklyn Healthworks HMO
  • EmblemHealth-GHI , HMO
  • EmblemHealth-HIP, Essential Plan 1 and 2
  • EmblemHealth-HIP, Essential Plan 3 and 4
  • EmblemHealth-HIP, Exchange
  • Empire BCBS,EPO/PPO/Indemnity POS/NYS and NYC Plans
  • Empire BCBS,HMO/POS
  • Empire BCBS Healthplus, Medicaid and HARP
  • Empire BCBS Healthplus, Medicare
  • Empire BCBS Healthplus, Essential 1 & 2
  • Empire BCBS Healthplus, Essential 3 & 4
  • Empire BCBS Healthplus, Exchange
  • Equian ,PPO
  • Fidelis
  • Fidelis, Essential Plan 1 and 2
  • GEHA
  • UMR
  • You May Like: What Age Does Medicare Eligibility Start

    When Can You Enroll

    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 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.

    Urgent Care Center Network

    MediCARE vs. MediCAID | Medicaid Programs and How They Affect Your Medicare

    Get the care you need when you need it at an urgent care center in our network no appointment needed. Urgent care centers offer late-night and weekend hours, often with faster service at a lower cost than the emergency room . Visit an in-network urgent care center to get help with non-emergency health issues like earache, upset stomach, and sprains for wounds that need stitches and more.

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    Annual And Open Enrollment Periods

    If youre unhappy with your current plan, have moved, or had a change in income, give us a call today and well make it easy for you to switch your Medicare coverage.

    Medicare Annual Enrollment Period

    During this period, you can

    • switch from Original Medicare to Medicare Advantage, or back to what you had.
    • switch from one Medicare Advantage plan to another, or from one Medicare Part D plan to another.

    Note: if you didnt enroll in a Medicare Part D plan when you were first eligible, you can do so during this period.

    Medicare Advantage Open Enrollment Period

    During this period, you have the one-time opportunity to

    • switch from one Medicare Advantage plan to a different one.
    • switch from your Medicare Advantage plan and return to Original Medicare.

    Notes Comments And Feedback

    Despite our very best efforts to allow anybody to adjust the website to their needs, there may still be pages or sections that are not fully accessible, are in the process of becoming accessible, or are lacking an adequate technological solution to make them accessible. Still, we are continually improving our accessibility, adding, updating and improving its options and features, and developing and adopting new technologies. All this is meant to reach the optimal level of accessibility, following technological advancements. For any assistance, please reach out to

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    The Mount Sinai Health System And Healthfirst Today Announced The Establishment Of A New Medicare Advantage Plan For Manhattan Residents To Be Co

    • New York

    The Mount Sinai Health System and Healthfirst today announced the establishment of a new Medicare Advantage plan for Manhattan residents to be co-sponsored by a health system and a Medicare insurer. The Healthfirst Mount Sinai Select plan, like other Medicare Advantage plans, is an alternative to the traditional Medicare program and allows Medicare beneficiaries to secure private insurance coverage financed by the federal government.

    We are very proud to partner with Healthfirst in providing this new, innovative model of care, said Kenneth L. Davis, MD, CEO and President of the Mount Sinai Health System. This plan gives members affordable and exclusive access to Mount Sinais top-rated network of doctors and specialists.

    Healthfirst is very pleased to be at the forefront of provider-payer collaboration through this innovative partnership with Mount Sinai, one of the finest health care systems in the world, said Pat Wang, Chief Executive Officer of Healthfirst. Our partnership will blend the best elements of our well-established Medicare Advantage plan infrastructure with the outstanding innovation and clinical excellence of the Sinai system to create a cost-efficient, superb new offering for Medicare members.

    For more information on Healthfirst, visit

    About the Mount Sinai Health System

    For more information, visit or find Mount Sinai on , and .

    What Is Medicare Advantage

    Senior Healthcare Analyst

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

    You may prefer a Medicare Advantage plan if youd like extra coverage for things that traditional Medicare doesnt cover, such as prescription drug benefits or vision, dental, and other services.

    Medicare Advantage plans arent 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.

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    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 youre curious whether Healthfirst offers a Medicare Advantage plan in your area, you can use Medicares plan finder tool.

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

    Healthfirst plans include the following:

    What Is Cin Number In Healthcare

    The Client Identification Number or CIN is a unique number assigned to each Medicaid recipient. This number is used by the pharmacy and other providers to submit claims to Medicaid fee-for-service . All Medicaid recipients are assigned a unique CIN even if they are enrolled in a Medicaid managed care plan.

    Recommended Reading: How Many Parts Medicare Has

    I Have Medicaid Will I Pay Less For Medicare Coverage

    Yes. When you are dual eligible, most of your healthcare costs will be covered by Medicare .

    Medicaid members can get Medicare coverage through either Original Medicare or a Medicare Advantage plan.

    As a Medicaid member, you may benefit from:

    Extra Help: Help with what, you ask? Some or all of your prescription drug coverage premiums, deductibles, coinsurance, and/or copayments.

    People with Medicaid get Extra Help automatically when they enroll in Medicare. Those without Medicaid who qualify for Extra Help must enroll on their own through the Social Security Administration.

    Medicare Savings Program: This program helps pay your Medicare Part A and/or Part B premiums, deductibles, and/or coinsurance. You may have to enroll in the Medicare Savings Program separately, even if you already have Medicaid.

    The Medicare Savings Program also allows you to sign up for an Original Medicare plan outside of your Initial Enrollment Period and before the General Enrollment Period.

    Special Needs Plans : This type of Medicare Advantage plan provides dual-eligible members with added benefits and savings, at little or no cost to them.

    Health System/hospital Affiliations Of Citymd And Its Providers

    What’s the Difference Between Medicaid and Medicare?

    As urgent care providers, CityMD providers do not generally admit patients seen at CityMD to hospitals. Rather, those in need of hospital services are expeditiously referred to the hospital through the emergency department of the hospital.

    CityMD maintains collaborative relationships with many of the area hospitals and health systems. When a CityMD patient is in need of medical services that are not provided by CityMD, CityMD seeks to assist the patient in obtaining appointments to high quality services in the community, both primary care and specialist.

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    What If Im Not Happy With The Medicare Coverage I Choose

    You can change it. Every year, youll have the opportunity to switch plans during an Annual Enrollment Period that runs from October 15 to December 7. Changes made during this period take effect January 1 of the following year.

    If you have certain life changesfor example, you move or become eligible for certain assistance programsyou may be able to switch plans at other times. And if you are eligible for both Medicaid and Medicare, you can switch once a quarter.

    Can Someone Explain Cost To Me Simply

    Wed be glad to. Typically, there are costs you pay and costs your Medicare plan pays. The types of costs you have can vary. For example, Original Medicare may have different costs than a Medicare Advantage plan .

    There are two basic types of cost:

    1. Your regular monthly payment for healthcare coverage

    2. Your share of the cost for healthcare services you receive

    Lets see how each of these costs work:


    For most people, there is no monthly premium for Part A . The federal government assesses a Part B premium, which usually is deducted right from your Social Security benefits.

    With a Medicare Advantage plan , youll pay the Part B premium plus an additional plan premium, but there are options with very low or even $0 monthly plan premiums.

    There are separate premiums for a Medicare prescription drug plan and Medigap policy .


    This is a set amount you may need to pay for healthcare services before your Medicare coverage starts paying its share. Until your total costs reach this amount, you pay.


    When you see a doctor or specialist, visit a hospital or other facility, or have a medical procedure done, this is the amount you may need to pay at the time of your visit.


    Plans with coinsurance typically split the cost of covered healthcare services with you after you pay any deductible. You might pay 20%, for instance, while your plan pays 80%.

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    Healthfirst Medicaid Prior Auth


    Plan Name: Healthfirst Plan Phone No.: 1-877-433-7643 Plan Fax No.: 1-866-848-5088 Website: www. healthfirst .org NYS MedicaidPrior Authorization Request Form for Prescriptions Rationale for Exception Request or Prior Authorization All information must be complete and legible Patient Information First Name: Last Name: MI: Male Female.

    What Are The Parts Of Medicare

    Healthcare Analyst

    When you first apply for Medicare, you are signing up for Parts A and B . Once youre enrolled, you have the option to join a Medicare Advantage plan which covers the benefits and services that Original Medicare offers plus a whole lot more like dental, vision, and prescription drug coverage. Not all Medicare Advantage plans include prescription drug coverage, so you may need to enroll in a separate prescription drug plan . today to learn about Medicare Advantage plan options.

    Read Also: What Age Qualifies You For Medicare

    Does Healthfirst Cover Infertility Treatment

    Healthfirst covers services for the diagnosis and treatment of infertility when such infertility is the result of malformation, disease or dysfunction. Such coverage is available as follows:

    1. Basic Infertility Services. Basic infertility services will be provided to a Member who is an appropriate candidate for infertility treatment.

    In order to determine eligibility, We will use guidelines established by the American College of Obstetricians and Gynecologists, the American Society for Reproductive Medicine, and the State of New York.

    However, Members must be between the ages of 21 and 44 in order to be considered a candidate for these services.

    Basic infertility services include:

    Healthfirst Announces New Otc Plus Cardwith More Ways To Save And More Places To Use Itas Part Of Its Medicare Advantage Offerings For 2022

    New OTC Plus card allowance can be used for items to promote a healthy lifestyle, from over-the-counter medications to healthy foods, Internet service, and fitness equipment and trackers

    NEW YORK, October 01, 2021—-Healthfirst, one of the largest individual Medicare Advantage HMO plans in the New York metro areai, today announced its 2022 Medicare Advantage plans, which include over-the-counter card allowances of up to $170 per monthii. A new OTC Plus card, available with the companys Dual Eligible Special Needs Plans ,iii can be used in more ways and in more places than typical OTC cards. It can be used for covered over-the-counter items as well as healthy foods, for Internet service, exercise equipment, activity trackers, and more based on the members specific health needs. The OTC Plus card is accepted at national chain pharmacies, independent pharmacies, specialty markets, and GrowNYC markets throughout the boroughs where healthy foods and produce can be purchased.

    This press release features multimedia. View the full release here:

    Healthfirst Medicare Advantage Plans can save you money on dental, vision, and healthy foods.

    More Choices, More Ways to Personalize Plans to Live a Healthy and Happy Life

    “Our plans are designed to keep our members healthy so they can do what makes them happy in life. We do this through our convenient access to care and money-saving benefits,” said Cohen-Smith.

    About Healthfirst

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    When Does Medicare Pay First And Health Plan Pay Second

    When youre eligible for or entitled to Medicare because you have End-Stage Renal Disease , during a coordination period of up to 30 months, the group health plan pays first and Medicare pays second. After the coordination period, Medicare pays first and the group health plan pays second.

    Some people with Medicare have other health coverage that must pay before Medicare pays its share of the bill . This guide tells you how Medicare works with other kinds of coverage and who should pay your bills first .

    After the coordination period, Medicare pays first and the group health plan pays second. If you originally got Medicare due to your age or a disability other than ESRD, and your group health plan was your primary payer, then it still pays first when you become eligible because of ESRD.

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