Jeffrey Wade
Healthfirst offers a range of health insurance plans for individuals and families, including Medicare Advantage, Medicaid Managed Care, Child Health Plus, and the Essential Plan. The company provides plans with monthly premiums as low as $0 and offers financial assistance to those who qualify. To apply for a Healthfirst insurance plan, you can contact the company by phone or in person, or request a call from a sales team member. You can also visit their Virtual Community Office to connect with a local representative. Before applying, it is recommended to use their Enrollment Checklist to gather the necessary information, such as age, household size, and income, which will determine your eligibility and plan options.
| Characteristics | Values |
|---|---|
| Location | New York |
| Website | https://healthfirst.org/ |
| Contact | 1-844-434-7785 |
| N/A | |
| Address | N/A |
| Application Methods | By phone, in person |
| Application Requirements | Age, household size, income, and other personal information |
| Plan Types | Individual, family, Medicare Advantage, Medicaid, Child Health Plus, Essential Plan, Leaf, Leaf Premier |
| Plan Features | $0 prescription drugs, OTC Plus or OTC card, $0 deductible, no copays, doctor visits, lab tests, prescription drugs, hospitalization |
| Plan Costs | Monthly premiums as low as $0, $20 per month for the Essential Plan |
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What You'll Learn
Eligibility criteria
Healthfirst offers health insurance plans for individuals and families in New York. The eligibility criteria for Healthfirst insurance plans vary depending on the specific plan and the applicant's circumstances. Here are the detailed eligibility criteria to help you understand which plan you may qualify for:
Income and Affordability:
Healthfirst considers your income when determining eligibility for certain plans and financial assistance. The Essential Plan, for instance, is designed for lower-income New Yorkers who don't qualify for other health insurance options. If you have a low income and don't qualify for Medicaid, Child Health Plus, or employer-provided health coverage, you may be eligible for the Essential Plan.
Additionally, if you have Medicare and earn less than $2,446 per month as an individual or $3,299 per month as a married couple, you may qualify for savings through the Medicare Savings Program or Medicaid. Healthfirst also offers financial assistance to those who qualify, and the amount of assistance depends on your income, family size, and the plan you select.
Age:
Healthfirst's plans are generally available to individuals and families under the age of 65. However, there may be exceptions, and it's best to contact Healthfirst directly to discuss your specific situation.
Immigration Status:
All documented immigrants, even those who have been in the United States for less than five years, can purchase insurance through NY State of Health. Undocumented parents can also apply for health insurance for their children.
Life Events:
You may experience what is known as a Qualifying Life Event (QLE), which can impact your eligibility for certain plans. These events include birth or adoption, pregnancy, marriage, divorce, a new job, a change in income or job loss. If you've had a QLE, you may be eligible for a new or different Healthfirst plan or financial assistance.
To determine your specific eligibility for Healthfirst insurance plans and find the most suitable option for your needs and budget, it is recommended to contact Healthfirst directly or seek assistance from their sales representatives or Patient Benefits Counselors. They will guide you through the application process and help you understand the eligibility criteria for different plans.
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Enrollment checklist
Before you apply for a Healthfirst insurance plan, it is important to have all the necessary information ready to make the application process as smooth as possible. Here is an enrollment checklist to help you prepare:
- Coverage type: Are you applying for coverage just for yourself, or do you need a family plan? Knowing this will help determine the specific plan that is right for you.
- Personal information: Have your personal details ready, including your full name, date of birth, address, and Social Security number (if you have one). You will also need to provide information on your current health status, any pre-existing medical conditions, and your family's medical history.
- Income and household details: Your income, household size, and family composition will impact your eligibility for certain plans and financial assistance. Have documentation ready to verify your income, such as pay stubs, tax returns, or bank statements.
- Existing insurance: If you already have health insurance, gather information about your current plan, including the type of coverage, any premiums or deductibles you pay, and your policy number.
- Preferred providers: Make a list of your preferred doctors, hospitals, or healthcare providers. Check if they are in-network with Healthfirst to ensure your care is covered.
- Medications: If you take any prescription medications, make a list of them. This will help you understand if they are covered by the Healthfirst prescription drug plan.
- Government programs: Research and understand your eligibility for government programs such as Medicaid, Child Health Plus, or the Essential Plan. These programs offer low-cost or free coverage and can be applied for at any time during the year.
- Financial assistance: Determine your need for financial assistance in paying for health insurance. Healthfirst offers financial assistance to those who qualify, and your income and family size will be factors in determining eligibility.
- Plan selection: Research the different Healthfirst plans available, such as the Essential Plan, Medicaid Managed Care, Child Health Plus, or Marketplace plans. Consider your budget, healthcare needs, and the specific benefits included in each plan.
- Contact Healthfirst: Once you have gathered all the necessary information, contact Healthfirst by phone or visit their Virtual Community Office to speak with a representative. They can guide you through the enrollment process and help you choose the best plan for your needs.
Remember, Healthfirst offers plans for all ages, needs, and income levels. Don't hesitate to reach out and ask for help in understanding your options and navigating the enrollment process.
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Open enrollment
Healthfirst offers a range of health insurance plans for individuals and families in New York. The company provides plans for all ages, needs, and income levels, and their health insurance specialists can help you find and apply for a suitable plan.
It is important to note that you can also enroll outside of the Open Enrollment Period if you experience a Qualifying Life Event (QLE). These events include significant life changes such as birth or adoption, pregnancy, marriage, divorce, a new job, a raise or change in work hours, or job loss. If you have had a QLE, you may be eligible for a new or different health plan, and you may also qualify for financial assistance.
To apply for a Healthfirst insurance plan during Open Enrollment or after experiencing a QLE, you will need to gather some important information beforehand. This includes determining whether you are seeking coverage for yourself or your family, as well as providing details such as your age, household size, income, and other personal information.
Healthfirst offers multiple ways to enroll, including over the phone or in person. They also provide an Enrollment Checklist to help guide you through the process and ensure you have all the necessary information.
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Qualifying life events
A Qualifying Life Event (QLE) is a major life-changing event that can make you eligible for a new or different health plan outside of the Open Enrollment Period. Healthfirst defines QLEs as birth or adoption, pregnancy, marriage, divorce, a new job, a raise or change in hours, or job loss. Other sources also include turning 26 and moving to a different zip code, county, or state that changes your health plan area as QLEs.
If you experience a QLE, you may be asked for documents to confirm the life event. The type of documentation you need depends on the type of qualifying life event. For example, if you have added family members, you may need to provide birth certificates, adoption records, or marriage licenses. If you have lost a family member who previously provided you with health insurance coverage, you may need to provide divorce paperwork or a death certificate. If you have moved, you may need to provide new rental agreements, deeds, or mortgages that show you have moved to a new health insurance plan area.
If you think you have experienced a QLE, you should contact your health insurer or the Marketplace to understand what documents might be necessary for eligibility. You can also visit healthcare.gov for more information about QLEs and Special Enrollment Periods.
It is important to note that certain plans have specific enrollment periods during which you can sign up or switch plans. However, if you have experienced a QLE, you may qualify for a Special Enrollment Period (SEP) and be able to enroll outside of the Open Enrollment Period.
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Payment and coverage
Healthfirst offers a range of health insurance plans to cater to different needs, including Medicare Advantage, Individual & Family, Essential Plans, Medicaid, Child Health Plus, and Marketplace Plans. These plans vary in terms of eligibility, premiums, deductibles, and benefits offered.
When it comes to payment and coverage, Healthfirst considers factors such as age, household size, income, and other personal information to determine eligibility and the extent of coverage.
For individuals seeking doctor visits, lab tests, prescription drugs, and hospitalization services, Healthfirst offers plans with $0 monthly premiums and $0 deductibles. These plans are available to qualified individuals aged 19 to 64, with the option of adding prescription drug coverage (Part D) or switching to a Medicare Advantage plan.
For families and individuals under 65, Healthfirst provides plans that include doctor visits, lab tests, prescription drugs, and hospitalization. These plans have variable deductibles and monthly premiums that depend on the specific plan chosen, family size, and income. Financial assistance is available for those who qualify.
Medicaid Managed Care members, including those with limited income and resources, can benefit from Healthfirst's plans that cater to their specific needs, with most healthcare costs covered. Additionally, Healthfirst offers a low-cost health insurance plan for qualified children under the age of 19, with $0 deductibles and no copays, regardless of family income or immigration status.
It is important to note that Healthfirst's plans may have specific enrollment periods, but individuals can enroll outside the Open Enrollment Period if they experience a Qualifying Life Event (QLE). To ensure you find the right plan, Healthfirst representatives are available to guide you through the process and answer any questions.
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Frequently asked questions
You can apply for Healthfirst Insurance over the phone, or in person. You will need to provide information about your age, household size, income and other personal information to determine which plan(s) you’re eligible for.
Healthfirst Insurance offers plans with monthly premiums as low as $0. The deductible and monthly premium depend on the plan, family size, and income. Financial assistance is available to those who qualify.
Healthfirst Insurance offers plans for individuals and families, including Medicare Advantage, Medicaid Managed Care, Child Health Plus, and the Essential Plan.
