Healthfirst offers Medicare Advantage plans in select New York counties, including NYC. Plans include PPOs, HMOs that do not need a referral for in-network providers, and some Special Needs Plans.
Healthfirst currently offers Medicare Advantage plans only in New York state. Covered areas include New York City’s five boroughs, as well as the following counties:
- Nassau
- Orange
- Rockland
- Sullivan
- Westchester
Read on to learn more about the Medicare Advantage plans that Healthfirst offers to residents of certain New York areas.
In New York, Healthfirst Medicare Advantage plans offer coverage similar to that provided by Original Medicare plus additional services that Original Medicare doesn’t cover. You can refer to the specific plan’s information regarding costs for these services. Some are offered with a $0 copayment.
Additional services may include:
- hearing and hearing aids
- vision and eyeglasses
- SilverSneakers fitness program
- transportation to medical appointments
- an allowance for buying over-the-counter items
- acupuncture coverage for certain health conditions
With the exception of one PPO plan, Most of Healthfirst’s Medicare Advantage plans are Health Maintenance Organization (HMO) plans, and availability will depend on where you live.
All of the following offered plans also include Part D (prescription drug coverage):
- Increased Benefits Plan (HMO)
- 65 Plus Plan (HMO)
- Signature (HMO)
- Signature (PPO)
Healthfirst also offers several Special Needs Plans (SNPs). These are HMO plans specifically designed for those who qualify for both Medicare and Medicaid.
The offered plans are:
- Life Improvement Plan (HMO D-SNP)
- CompleteCare (HMO D-SNP)
- Connection Plan (HMO D-SNP)
Coverage depends on the plan, but some benefits they may offer include:
- Part D prescription drugs
- dental benefits
- long-term care
- adult day healthcare
- SilverSneakers fitness program
In addition, Healthfirst offers a Senior Health Partners Managed Long-Term Care (MLTC) Plan with similar benefits.
The following are some examples of Healthfirst’s Medicare Advantage plans and their costs in different locations for 2025.
| Healthfirst Coordinated Benefits Plan (HMO), Queens | Healthfirst Increased Benefits Plan (HMO), Brooklyn | Healthfirst 65 Plus Plan (HMO), Bronx | Healthfirst Increased Benefits Plan (HMO), Westchester | Healthfirst Signature (PPO), Manhattan | |
|---|---|---|---|---|---|
| Monthly premium with drug coverage | $0 | $36.10 | $0 | $36.10 | $0 |
| Health plan deductible per year | $0 | $0 | $0 | $0 | $0 |
| Drug deductible per year | $590 | $590 | $590 | $590.00 | $590.00 |
| In-network out-of-pocket max | $6,700 | $9,350 | $9,350 | $9,350 | $5,000 |
| Primary doctor copay per visit | $10 | $0 | $0 | $0 | $0 |
| Specialist copay per visit | $30 | $20 | $25 | $20 | $35 |
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.
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.
Healthfirst offers several Medicare Advantage plans to residents of certain areas of New York state. The plans largely use an HMO model and include SNPs for those who need long-term care or are enrolled in Medicaid.
To learn more about available Medicare Advantage plans, visit Medicare.gov or call 800-MEDICARE (800-633-4227).