2013 Coordinated Benefits Plan (HMO) - Benefits
This plan covers:
- $0 copay for Primary Care Visits
- $20 copay for Specialist Visits
- $0 annual routine eye exam
- Up to $500 for hearing aids every 3 years
- Enhanced vision, dental and hearing care
- $0 copay for dental cleanings, exams and x-rays, plus enhanced benefits with low out-of-pocket copays
- Up to 8 round trips per year (2 per quarter) of FREE car service to and from a Healthfirst doctor
The benefit information provided herein is a brief summary, not a comprehensive description of benefits. For more information contact the plan. You must continue to pay your Medicare Part B premium if not otherwise paid for under Medicaid or by another third party. Limitations, copayments, and restrictions may apply.
*Premiums, copays, co-insurance, and deductibles may vary based on the level of help that beneficiaries may receive; beneficiaries should contact the plan for further details.
Healthfirst Medicare Plan is a Coordinated Care plan with a Medicare contract and a contract with the New York Medicaid program.
H3359_MKT13_17 CMS Approved 11152012
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