Marketplace plans are for individuals and family members under the age of 65. Marketplace Leaf plans cover the essential health benefits you need to feel secure. Marketplace Leaf Premier plans provide the same health benefits as Marketplace Leaf plans, plus adult vision and dental care.
Within New York City’s five boroughs (the Bronx, Brooklyn, Manhattan, Queens, and Staten Island), Long Island, and Westchester.
Deductible (individual) Platinum Leaf $0 Platinum Leaf Premier $0 Maximum Out-of-Pocket (individual) Platinum Leaf $2,000 Platinum Leaf Premier $2,000 Deductible (Family) Platinum Leaf $0 Platinum Leaf Premier $0 Maximum Out-of-Pocket (Family) Platinum Leaf $4,000 Platinum Leaf Premier $4,000 Your Annual Checkup Platinum Leaf $0 copay Platinum Leaf Premier $0 copay Primary Care Provider (PCP) Visit Platinum Leaf $15 copay Platinum Leaf Premier $10 copay Dental Care Adult Platinum Leaf Not covered Platinum Leaf Premier $10 copay Dental Pediatrics (up to Age 19) Platinum Leaf $15 copay Platinum Leaf Premier $10 copay Vision Exams Platinum Leaf Not covered Platinum Leaf Premier $10 copay Vision Exams Pediatrics (up to Age 19) Platinum Leaf $15 copay Platinum Leaf Premier $10 copay Telemedicine (Teladoc) Platinum Leaf $0 copay Platinum Leaf Premier $0 copay Specialist Visit Platinum Leaf $35 copay Platinum Leaf Premier $40 copay Retail Health Clinic Platinum Leaf $15 copay Platinum Leaf Premier $10 copay Urgent Care Platinum Leaf $55 copay Platinum Leaf Premier $55 copay Emergency Room Platinum Leaf $100 copay Platinum Leaf Premier $100 copay Platinum Leaf $100 copay Platinum Leaf Premier $100 copay Platinum Leaf $100 copay Platinum Leaf Premier $100 copay Outpatient Facility Platinum Leaf $100 copay Platinum Leaf Premier $100 copay Inpatient Hospital Stay Platinum Leaf $500 copay per admission Platinum Leaf Premier $500 copay per admissionTalk to a doctor any time—for a $0 copay. Connect with board-certified doctors through video chat or phone for prescriptions, help diagnosing and treating non-emergency conditions, and more. Access to dermatologists is also available.
Healthfirst makes working out affordable too! For just $28/month, you get a standard membership to a fitness center in your area. Premium fitness center options are available for an additional fee. Track your activity, monitor your progress, achieve your fitness goals, and so much more! Visit activeandfitdirect.com to learn more.
E8F603C3-4D94-4DCE-818B-75031FE268CE Created with sketchtool.Physical activity is one of the simplest ways to stay healthy, and Healthfirst makes it even more rewarding! With the Active&Fit ExerciseRewards ™ program, you can earn $200 every six months if you visit a qualifying fitness center at least 50 days during the same six-month reward period. Contact ExerciseRewards at 1-877-810-2746 to learn more about qualifying fitness centers.
This information is not a complete description of benefits. Contact the plan for more information. Benefits, premiums, and/or copayments/coinsurance may change on January 1 of each year.
Coverage is provided by Healthfirst PHSP, Inc.
Plans contain exclusions and limitations.
Healthfirst complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex.
ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 1-866-305-0408 (TTY 1-888-867-4132). 注意：如果您使用繁體中文，您可以免費獲得語言援助服務。請致電 1-866-305-0408 (TTY 1-888-542-3821)。
Telemedicine (Teladoc) isn't a replacement for your primary care provider (PCP). Your PCP should always be your first choice for care (both in-person and virtual visits).
DentaQuest® is contracted with Healthfirst to provide dental benefits to its members.
EyeMed® is contracted with Healthfirst to provide vision benefits to its members.
* Up to $400 during coverage year; up to an additional $200 during coverage year for spouse.