BackThe Essential Plan
Plans with access to essential health benefits like doctor visits, lab tests, prescription drugs, hospitalization, urgent care, emergency care, vision, dental, and more—all for a $0 monthly plan premium. These plans are for qualified individuals ages 19–64.
Plan Highlights:
- No-cost annual checkups
- Hospital, emergency room and urgent care visits
- Lab tests and X-rays
- Prescription drug coverage
- Maternity and newborn coverage
- No-cost dental and vision coverage*
- 24/7 access to care with telemedicine (Teladoc)**
- Physical, occupational, and speech therapy
- Annual gym membership reimbursement†
- 2022
- 2021
Plans
For covered prescription drugs, the Maximum Out-of-Pocket limit is $50 per calendar quarter.
For Covered Prescription Drugs, there will be a $50 copay maximum out of pocket per calendar quarter.
Note: Due to changes in New York State regulation, as of June 1, 2021:
• Essential Plan 1 and Essential Plan 1 Plus Dental & Vision cost-sharing and benefits are the same.
• Essential Plan 2 and Essential Plan 2 Plus Dental & Vision cost-sharing and benefits are the same.
*Dental services must be medically necessary to be covered; limitations apply.
**Telemedicine isn’t a replacement for your Primary Care Provider (PCP). Your PCP should always be your first choice for care (both in-person and virtual visits).
†Up to $200 per reward period. There are two reward periods—January through June, and July through December.
††Based on 2020 earnings. The income ranges shown are for individuals only. The income ranges may increase based on the eligible members in your household. To learn more, talk to a Healthfirst representative.
The benefit information provided is a brief summary, not a complete description, of benefits. For more information, contact the plan.
Coverage is provided by Healthfirst PHSP, Inc. Plans contain exclusions and limitations.
Additional Benefits
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24/7 Access to Telemedicine with Teladoc*
Talk to a doctor any time—for a $0 copay. Connect with board-certified doctors through video chat or phone for prescriptions, help diagnosing and treating non-emergency conditions, and more. 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 (both in-person and virtual visits).
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Active & Fit Direct
Working out just got cheaper. For just $25/month plus a one-time enrollment fee of $25, you can get a standard membership to a fitness center in your area. Track your activity, monitor your progress, achieve your fitness goals, and so much more. (Note: a three-month membership commitment is required up front.)
Call Active&Fit Direct at 1-877-810-2746, Monday to Friday, 8am—9pm, to learn more and find out how you can join.
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Rewards for Working Out
With the Active&Fit ExerciseRewards™ program,** you can earn $200 every six months if you visit a qualifying fitness center at least 50 days during the same six-month reward period. Your covered spouse or domestic partner can also get rewarded $100 every six months for going to the gym 50 days or more. † Visit ActiveandFit.com or talk to an Active&Fit ExerciseRewards representative at 1-877-810-2746, Monday to Friday, 8am—9pm.
**Up to $200 per reward period. There are two reward periods—January through June, and July through December.†Up to $100 per reward period. There are two reward periods—January through June, and July through December.
Additional Benefits
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24/7 Access to Telemedicine with Teladoc*
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Active & Fit Direct
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Rewards for Working Out
Frequently Asked
Questions
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Who is eligible to enroll?
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Why should I choose Healthfirst?
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Support When You Need It
We're happy to answer your questions.
Learn about enrollment
1-844-488-1486
Monday to Friday, 9am–8pm
TTY English: 1-888-542-3821
TTY Español: 1-888-867-4132
Member Services
1-888-250-2220
Monday to Friday, 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 our Virtual Community Office to connect with a local Healthfirst representative or to find a community office near you.
You can also go to the NY State of Health’s website to view your choices, or call the NY State of Health customer service center at 1-855-355-5777.
We look forward to helping you!
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