AbsoluteCare FIDA Plan (Medicare-Medicaid Plan)

The Healthfirst AbsoluteCare FIDA Plan is a Fully Integrated Duals Advantage (FIDA) plan that offers members the benefits of Original Medicare and Medicaid, plus prescription drug coverage, dental, vision, hearing, routine transportation, and 24/7 access to care with the Nurse Help Line. And you don’t need referrals to see in-network specialists. A FIDA plan is an organization made up of doctors, hospitals, pharmacies, providers of long-term services and supports, Care Managers, Interdisciplinary Teams (IDTs), and other providers working together to provide the care you need. This plan is designed for people who have both Medicare and full Medicaid, who are age 21 or older, and who require community-based, long-term care services or reside in a nursing home.

Plan Highlights:

  • Prescription drug coverage
  • Dental
  • Vision exams and eyeglasses
  • Hearing exams and hearing aids
  • Routine transportation
  • Community-based, long-term care services
  • Behavioral health services
  • 2019
Healthfirst AbsoluteCare FIDA
Summary of Benefits and Coverage (PDF)
English
Premium
$0
Eligible Age
21 or older
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
You are entitled to Medicare Part A, enrolled in Medicare Part B, and eligible for Medicare Part D
You are eligible for Medicaid
You require 120 or more days of community-based or facility-based LTSS, are nursing facility clinically eligible, and receive facility-based, long-term support services, or are eligible for the Nursing Home Transition and Diversion (NHTD) 1915(c) waiver
You are not excluded from enrollment based on one of these exceptions
Dental
$0 copay
Vision
$0 copay
Hearing
$0 copay
Nurse Help Line Access
$0 copay
Free Rides
FREE transportation to/from your doctor or pharmacy for covered services
More Plan Information

Additional Plan Highlights

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

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

  • Community-based, long-term services and supports

    As a Participant in Healthfirst AbsoluteCare FIDA Plan, you’ll get a comprehensive assessment of your needs, including your need for community-based or facility-based long-term services and supports (LTSS). All your needs, as identified in your assessment, will be addressed in your Person-Centered Service Plan (PCSP). Your PCSP will outline which LTSS you will get, from whom, and how often.

  • Behavioral Health Services

    As a Participant in Healthfirst AbsoluteCare FIDA Plan, you’ll get a comprehensive assessment of your needs, including your need for behavioral health services. All your needs, as identified in your assessment, will be addressed in your Person-Centered Service Plan (PCSP). Your PCSP will outline which behavioral health services you will get, from whom, and how often.

  • 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 care with the Nurse Help Line

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  • Community-based, long-term services and supports

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  • Behavioral Health Services

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  • Healthfirst Medication Therapy Management Program

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Frequently Asked
Questions

See All
  • Can I save money on my healthcare costs?
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  • How do I use my coverage at the pharmacy?
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  • Do generic drugs work as well as brand name drugs?
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Support When You Need It

We're happy to answer your questions.

Learn about enrollment

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TTY English: 1-888-542-3821

TTY Español: 1-888-867-4132

Member Services

1-855-675-7630

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TTY Español: 711

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