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Plans & Benefits - Practice Guidelines and Tips - 2024
Healthfirst at a Glance - Signature (HMO)

A Medicare Advantage plan that allows members to select only the benefits they need.

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At a Glance
  
Plans & Benefits - Practice Guidelines and Tips - 2024
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.

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At a Glance
  
Plans & Benefits - Practice Guidelines and Tips - 2024
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), which helps people with Medicare pay fewer drug costs.

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At a Glance
  
Plans & Benefits - Practice Guidelines and Tips - 2024
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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At a Glance
  
Plans & Benefits - Practice Guidelines and Tips - 2024
Healthfirst at a Glance - Connection Plan (HMO D-SNP)

A Medicare Advantage dual-eligible special needs plan that coordinates coverage for those who are newly Medicare-eligible and enrolled in our Medicaid Managed Care plan pursuant to the Centers for Medicare & Medicaid default enrollment process.

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At a Glance
  
Plans & Benefits - Practice Guidelines and Tips - 2024
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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At a Glance
  
Plans & Benefits - Practice Guidelines and Tips - 2024
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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At a Glance
  
Claims & Billing - Form - 2024
Prior Authorization Request - Podiatry and Peripheral Vascular Disease

Effective Jan. 1, 2024, Healthfirst resumed responsibility for management of prior authorization (PA) requests for Podiatry and Peripheral Vascular Disease. Starting Jan. 1, 2024, you may submit PA requests for these services to Healthfirst for dates of service on or after Jan. 1, 2024, by using this fax form. To submit your request via our Online Authorization tool, visit our Healthfirst Provider Portal at hfproviderportal.org. To create an account, select "Create your account." You may also contact your Healthfirst account manager.

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Prior Authorization
  
Provider Alerts - Behavioral Health and Foster Care - Practice Guidelines and Tips - 2023
Cultural Competency Training for Participating Providers

New York State Department of Health requires providers and their office staff who have regular and substantial contact with Healthfirst members certify annually the completion of Cultural Competency Training.

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Behavioral Health
  
Claims & Billing - Form - 2024
Prior Authorization Request - Physical, Occupational, and Speech Therapies

Effective Jan. 1, 2024, Healthfirst has resumed responsibility for management of prior authorization (PA) requests for Physical, Occupational, and Speech Therapies. You may now submit PA requests for these services to Healthfirst for dates of service on or after Jan. 1, 2024. Please download this PDF of the fax request form or visit the Healthfirst Provider Portal at hfproviderportal.org to submit your request using our Online Authorization tool.

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Prior Authorization
  
Provider Alerts - Compliance, Regulatory & Policies - Practice Guidelines and Tips - 2024
New State Requirements for Provider Compliance Programs

New York State has made changes to provider requirements for starting and maintaining compliance programs.

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Quality and Compliance
  
Provider Alerts - Provider Resources - 2022
Healthfirst Connection Plan (HMO D-SNP) Announcement

Starting Jan. 1, 2024, Healthfirst will begin covering members in Healthfirst Connection Plan (HMO D-SNP), our newest Medicare Advantage Dual-Eligible Special Needs Plan. Read the Provider Alert for more details...

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Connection Plan
  
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