Life Improvement Plan (HMO SNP)

The Healthfirst Life Improvement Plan is a Medicare Advantage Dual-Eligible Special Needs Plan that offers members the benefits of Original Medicare and Medicaid, plus prescription drug coverage, over-the-counter benefits, the SilverSneakers® fitness program, and dental, vision, and hearing. And you don’t need referrals to see in-network specialists. This plan is designed for people who have both Medicare and Medicaid.

Plan Highlights:

  • Prescription drug coverage
  • Over-the-counter benefits
  • SilverSneakers® fitness program
  • Dental
  • Vision exams and eyeglasses
  • Hearing exams and hearing aids
  • Acupuncture
  • 2019
Life Improvement Plan (HMO SNP)
Summary of Benefits and Coverage (PDF)
English
Premium
$0
Eligible Age
65 or older (or under 65 with certain disabilities)
Eligible Location
Within New York City’s five boroughs (the Bronx, Brooklyn, Manhattan, Queens, and Staten Island), and Nassau and Westchester counties.
Other Eligibility Requirements
Qualify for Medicare Part A (you are 65 or older, or under 65 with certain disabilities)
Enroll in and continue to pay for Medicare Part B (Medicare Part B premium is covered for dual-eligible members with full Medicaid coverage)
Do not have End-Stage Renal Disease (ESRD) (permanent kidney disease requiring dialysis or a kidney transplant), except under certain limited circumstance
Are eligible for both Medicare and full Medicaid, or eligible for Medicare cost-sharing assistance under Medicaid
Over-the-Counter Benefit
$1,200 per year ($100 per month) for over-the-counter (OTC) nonprescription drugs and health-related items
Dental
$0 copay
Vision
$0 copay
Acupuncture
$0 copay for up to 30 acupuncture visits every year
Teladoc
$0 copay
Nurse Help Line Access
$0 copay
Free Rides
FREE transportation to/from your doctor or pharmacy—up to 16 one-way trips per year (additional trips covered by Medicaid, if you qualify)
Meal Delivery
$0 copay for up to 42 meals delivered to your home for up to 14 days following an inpatient hospital stay greater than two days, if recommended by a provider
More Plan Information

Additional Plan Highlights

  • 24/7 Access to Telemedicine with Teladoc*

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

    *Telemedicine isn’t a replacement for your Primary Care Provider (PCP). Your PCP should always be your first choice for care and for routine visits.

  • 24/7 Access to care with the Nurse Help Line

    Talk to a nurse any time—for a $0 copay. Get wellness advice and help finding a doctor.

  • Urgent Care Center Network

    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 (ER). 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.

  • SilverSneakers

    Get access to the SilverSneakers network of fitness facilities and to group exercise classes, classes held at parks and community locations, and at-home kits.

  • Healthfirst Medication Therapy Management Program

    The Healthfirst Medication Therapy Management (MTM) program is an in-depth, one-on-one review of all your medications (prescription drugs, over-the-counter nonprescription drugs, and herbal and nutritional supplements). The goal is to help you get the most from your medications. Services include

    • Phone consultation with a licensed pharmacist to complete a Comprehensive Medication Review (CMR). The call will take about 30 to 60 minutes and the pharmacist will answer any questions you may have (a CMR is usually offered once each year, if you qualify).
    • Medication Action Plan (MAP)
    • Medication recommendations may be sent to your provider from the MTM pharmacist, also known as Targeted Medication Review (TMR)
    • Personal medication list that lists all your medications

    Learn More

Additional Plan Highlights

  • 24/7 Access to Telemedicine with Teladoc*

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  • 24/7 Access to care with the Nurse Help Line

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  • Urgent Care Center Network

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  • SilverSneakers

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  • Healthfirst Medication Therapy Management Program

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Frequently Asked
Questions

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  • Can I save money on my healthcare costs?
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Support When You Need It

We're happy to answer your questions.

Learn about enrollment

1-877-237-1303

7 days a week, 8am—8pm

TTY English: 1-888-542-3821

TTY Español: 1-888-867-4132

Member Services

1-888-260-1010

7 days a week, 8am—8pm

TTY English: 1-888-542-3821

TTY Español: 1-888-867-4132

Can't talk right now?

Request a callback and we’ll get back to you within one business day.

You can also visit us in person at one of our community offices.

If you receive Medicaid and want to know whether you are eligible for a managed long-term care plan, you can call the Conflict-Free Evaluation and Enrollment Center (CFEEC) at 1-855-222-8350, Monday to Friday, 8:30am-8pm, and Saturday, 10:00am-6:00pm, to schedule a free evaluation.