2014 Coordinated Benefits Plan (HMO) - Eligibility and Cost
To receive coverage under the Healthfirst Coordinated Benefits Plan (HMO), you must meet the following qualifications:
- 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.
- Live in the Healthfirst service area: Bronx, Kings (Brooklyn), New York (Manhattan), Queens, Richmond (Staten Island), and Nassau counties.
- Do not have End-Stage Renal Disease (ESRD) (permanent kidney disease requiring dialysis or a kidney transplant), except under certain limited circumstances.
Members may enroll in the plan only during specific times of the year. Contact Healthfirst for more information.
There is no monthly plan premium for the Healthfirst Coordinated Benefits Plan (HMO).
Benefits, formulary, pharmacy network, provider network, premium and/or co-payments/co-insurance may change on January 1 of each year.
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.
The plan's contract with the Centers for Medicare & Medicaid Services is renewed annually. Availability of coverage beyond the end of the current contract year is not guaranteed.
Healthfirst Medicare Plan is an HMO plan with a Medicare contract and a contract with the New York Medicaid program. Enrollment in Healthfirst Medicare Plan depends on contract renewal.
H3359_MKT14_18 CMS Approved 10252013
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