Healthfirst Essential Plan 1 Medicaid is a type of health insurance that is available to low-income individuals and families who meet certain eligibility requirements. It is administered by Healthfirst, a health insurance company, and is part of the Medicaid program, which is a government-funded health insurance program. Healthfirst Essential Plan 1 Medicaid covers a range of medical services, including doctor visits, hospital stays, prescription drugs, and mental health care. The cost of the plan varies depending on income and family size, and in some cases, there may be no cost at all.
Healthfirst Essential Plan 1 Overview
Healthfirst Essential Plan 1 is a Medicaid health plan available to certain low-income individuals and families in New York. It provides comprehensive medical, dental, and vision coverage.
Eligibility
- To be eligible for Healthfirst Essential Plan 1, you must meet certain income and citizenship requirements.
- You must be a New York State resident.
- You must be a U.S. citizen, a permanent resident, or a qualified non-citizen.
- Your income must be at or below 138% of the federal poverty level (FPL).
Benefits
Healthfirst Essential Plan 1 covers a wide range of medical, dental, and vision services, including:
- Doctor visits
- Hospital care
- Prescription drugs
- Preventive care
- Mental health and substance abuse treatment
- Dental services
- Vision care
Costs
There are no monthly premiums for Healthfirst Essential Plan 1.
Copayments may apply for certain services. The amount of your copayment will depend on your income and the type of service you are receiving.
How to Apply
To apply for Healthfirst Essential Plan 1, you can:
- Visit the New York State of Health website.
- Call the New York State of Health Customer Service Center at 1-855-355-5777.
- Visit a local Department of Social Services office.
Contact Information
For more information about Healthfirst Essential Plan 1, you can:
- Visit the Healthfirst website.
- Call the Healthfirst Member Services Department at 1-800-444-1195.
| Service | Covered | Copayment |
|---|---|---|
| Doctor visits | Yes | $5 |
| Hospital care | Yes | $0 |
| Prescription drugs | Yes | $2-$4 |
| Preventive care | Yes | $0 |
| Mental health and substance abuse treatment | Yes | $5 |
| Dental services | Yes | $5-$10 |
| Vision care | Yes | $5 |
Who is Eligible for Healthfirst Essential Plan 1
Healthfirst Essential Plan 1 is a Medicaid managed care plan offered by Healthfirst. To be eligible for Healthfirst Essential Plan 1, you must meet the following criteria:
- Be a New York State resident
- Be a U.S. citizen or qualified non-citizen
- Be under the age of 65
- Meet the income and asset limits set by Medicaid
- Be pregnant or have children under the age of 19
- Be disabled or have a chronic health condition
In addition to the above criteria, you may also be eligible for Healthfirst Essential Plan 1 if you are receiving Supplemental Security Income (SSI) or Temporary Assistance for Needy Families (TANF).
| Family Size | Income Limit |
|---|---|
| 1 | $2,382 |
| 2 | $3,207 |
| 3 | $4,032 |
| 4 | $4,857 |
| 5 | $5,682 |
| 6 | $6,507 |
| 7 | $7,332 |
| 8 | $8,157 |
The income limits listed in the table are for a 12-month period. If your income is over the limit, you may still be eligible for Healthfirst Essential Plan 1 if you have high medical expenses.
To apply for Healthfirst Essential Plan 1, you can contact the New York State Department of Health or visit the Healthfirst website.
Benefits Covered by Healthfirst Essential Plan 1
Healthfirst Essential Plan 1 is a Medicaid plan that provides comprehensive coverage for eligible individuals and families. It is a managed care plan, which means that you will receive care from a network of providers. The plan covers a wide range of benefits, including:
- Doctor visits
- Hospital care
- Emergency services
- Mental health and substance abuse treatment
- Prescription drugs
- Lab and X-ray services
- Rehabilitation services
- Dental care
- Vision care
- Transportation to medical appointments
The plan also covers a number of preventive services, such as:
- Well-child visits
- Immunizations
- Cancer screenings
- Family planning services
The cost of Healthfirst Essential Plan 1 is based on your income and family size. You may be eligible for premium assistance, which can help lower your costs. To learn more about Healthfirst Essential Plan 1, you can call the customer service number on your ID card or visit the Healthfirst website.
| Category | Services | ||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Doctor Visits | Routine checkups, sick visits, specialist care | ||||||||||||||||||||||
| Hospital Care | Inpatient and outpatient hospital stays, emergency room visits | ||||||||||||||||||||||
| Emergency Services | Treatment for sudden, life-threatening conditions | ||||||||||||||||||||||
| Mental Health and Substance Abuse Treatment | Individual and group therapy, medication, detoxification | ||||||||||||||||||||||
| Prescription Drugs | Brand-name and generic medications | ||||||||||||||||||||||
| Lab and X-ray Services | Blood tests, MRIs, CT scans | ||||||||||||||||||||||
| Rehabilitation Services | Physical therapy, occupational therapy, speech therapy | ||||||||||||||||||||||
| Dental Care | Cleanings, fillings, extractions, dentures | ||||||||||||||||||||||
| Vision Care | Eye exams, glasses, contacts | ||||||||||||||||||||||
| Transportation to Medical Appointments | Bus tokens, taxi vouchers, mileage reimbursement |
| Benefit | Description |
|---|---|
| Preventive care | Well-child visits, cancer screenings, immunizations |
| Medical care | Doctor’s visits, hospital stays, surgery |
| Mental health care | Therapy, counseling |
| Prescription drug coverage | Wide range of prescription drugs |
| Dental care | Cleanings, fillings, X-rays |
| Vision care | Eye exams, glasses, contact lenses |
| Transportation | To and from medical appointments |
| Help finding a doctor | Assistance in finding a primary care doctor |
| Case management services | Help with coordinating care |
| Translation services | For non-English speakers |
Hey y’all, I hope this article has helped shine a light on the particulars of the Healthfirst Essential Plan 1 Medicaid, giving you the knowledge you need to make informed decisions about your healthcare. If you have any more questions or want to delve deeper into the topic, don’t hesitate to drop by again – there’s always more to uncover. Thanks for taking the time to read and remember, your health is worth the investment, so keep on learning and taking care of yourself. Catch you on the flip side!