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Compliance, Regulatory & Policies - Policy, Billing, or Coverage Update - 2026
Reimbursement Policy: PO-RE-162 Diagnostic Laboratory

This policy outlines Healthfirst's standards and requirements for the reimbursement of diagnostic laboratory services.

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Reimbursement Policy
  
Plans & Benefits - Practice Guidelines and Tips - 2026
2026 Healthfirst Plans at a Glance

Healthfirst has health plans made for New Yorkers.

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Healthfirst Plans
  
Plans & Benefits - Practice Guidelines and Tips - 2026
Healthfirst at a Glance - 65 Plus Plan (HMO)

A Medicare Advantage plan with hospital, medical, and prescription drug coverage all in one plan

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Healthfirst Plans
  
Plans & Benefits - Practice Guidelines and Tips - 2026
Healthfirst at a Glance - The Essential Plan

Federally subsidized plans for individuals who are ineligible for Medicaid due to income or immigration status.

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Healthfirst Plans
  
Plans & Benefits - Practice Guidelines and Tips - 2026
Healthfirst at a Glance - Child Health Plus (CHPlus)

A New York State-sponsored health plan for individuals under the age of 19.

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Healthfirst Plans
  
Plans & Benefits - Practice Guidelines and Tips - 2026
Healthfirst at a Glance - CompleteCare (HMO D-SNP)

A Medicaid Advantage Plus plan that combines Medicare and Medicaid benefits with long-term care services.

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Healthfirst Plans
  
Plans & Benefits - Practice Guidelines and Tips - 2026
Healthfirst at a Glance - Connection Plan (HMO D-SNP)

For those who are dual-eligible for both Medicare and cost-sharing assistance from Medicaid.

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Healthfirst Plans
  
Plans & Benefits - Practice Guidelines and Tips - 2026
Healthfirst at a Glance - Increased Benefits Plan (HMO)

A Medicare Advantage plan for eligible Medicare beneficiaries who qualify for Extra Help, also known as Low-Income Subsidy (LIS), which helps people with Medicare pay lower prescription drug costs.

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Healthfirst Plans
  
Plans & Benefits - Practice Guidelines and Tips - 2026
Healthfirst at a Glance - Leaf and Leaf Premier

Our Leaf and Leaf Premier plans offer two levels of coverage for individuals and families. They are Qualified Health Plans certified by the NYSOH marketplace.

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Healthfirst Plans
  
Plans & Benefits - Practice Guidelines and Tips - 2026
Healthfirst at a Glance - Life Improvement Plan (HMO D-SNP)

A Medicare Advantage special needs plan for individuals who are eligible for Medicare and Medicaid. Most Life Improvement Plan members have fee-for-service (FFS) Medicaid benefits administered by the New York State Department of Health.

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Healthfirst Plans
  
Plans & Benefits - Practice Guidelines and Tips - 2026
Healthfirst at a Glance - Medicaid Managed Care

A New York State-sponsored Medicaid plan for low-income individuals, families, and children.

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Healthfirst Plans
  
Plans & Benefits - Practice Guidelines and Tips - 2026
Healthfirst at a Glance - Personal Wellness Plan (PWP)

For Medicaid beneficiaries with serious mental health illness and/or substance use disorders.

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Healthfirst Plans
  
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