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Healthfirst Reward Card Program Form 3,5/5 7382 reviews. The processing period. Remember to make a copy of the completed Rewards request form for your. Call the Member Services number on the back of your Healthfirst ID card. The Healthfirst Rewards Program Team. Mail to: Fax to. GEHA health members can earn gift cards and health-related items. Your Healthfirst Card. Congratulations on receiving your Reward Card! You can ONLY use your card at the following participating merchant stores. We look forward to a healthy relationship with you and your family. For more information please click on the Main Menu located on the upper left hand corner. Get a $25 gift card. for your wellness exam and health assessment. As a part of the COT 2016–2017 wellness program, complete a wellness exam and online health assessment, and you’ll earn a $25 gift card!. You need to complete BOTH steps by September 30, 2016 to earn the reward. This wellness campaign is designed to help you become. New York Provider Manual revision 12/31/19 Page 2 Healthfirst® Established in 1993, Healthfirst® is a not-for-profit managed care organization that provides high-quality healthcare coverage to low-income individuals and families living in New York.
Health First Rewards Plan (HMO) H1099-014 is a 2019 Medicare Advantage or Medicare Part-C plan by Health First Health Plans, Inc. available to residents in Florida. This plan includes additional Medicare prescription drug (Part-D) coverage. The Health First Rewards Plan (HMO) has a monthly premium of $- and has an in-network Maximum Out-of-Pocket limit of $5,500 (MOOP). This means that if you get sick or need a high cost procedure the co-pays are capped once you pay $5,500 out of pocket. This can be a extremely nice safety net.
Health First Rewards Plan (HMO) is a Local HMO. With a health maintenance organization (HMO) you will be required to receive most of your health care from an in-network provider. Health maintenance organizations require that you select a primary care physician (PCP). Your PCP will serve as your personal doctor to provide all of your basic healthcare services. If you require specialized care or a physician specialist, your primary care physician will make the arrangements and inform you where you can go in the network. You will need your PCPs okay, called a referral. Services received from an out-of-network provider are not typically covered by the plan.
Health First Health Plans, Inc. works with Medicare to provide significant coverage beyond Part A and Part B benefits. If you decide to sign up for Health First Rewards Plan (HMO) you still retain Original Medicare. But you will get additional Part A (Hospital Insurance) and Part B (Medical Insurance) coverage from Health First Health Plans, Inc. and not Original Medicare. With Medicare Advantage Plans you are always covered for urgently needed and emergency care. Plus you receive all of the benefits of Original Medicare from Health First Health Plans, Inc. except hospice care. Original Medicare still provides you with hospice care even if you sign up for a Medicare Advantage Plan.
2019 Health First Health Plans, Inc. Medicare Advantage Plan Details
Name: | |
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ID: | H1099-014 |
Provider: | Health First Health Plans, Inc. |
Year: | 2019 |
Type: | Local HMO |
Monthly Premium C+D: | $- |
Part C Premium: | $0.00 |
MOOP: | $5,500 |
Part D (Drug) Premium: | $0.00 |
Part D Supplemental Premium | $0.00 |
Total Part D Premium: | $0.00 |
Drug Deductible: | $0.00 |
Tiers with No Deductible: | 0 |
Gap Coverage: | No |
Initial Coverage Limit: | $3820 |
Benchmark: | not below the regional benchmark |
Type of Medicare Health: | Enhanced Alternative |
Drug Benefit Type: | Enhanced |
Part-C Premium
Health First Health Plans, Inc. plan charges a $0.00 Part-C premium. The Part C premium covers Medicare medical, hospital benefits and supplemental benefits if offered. You generally are also responsible for paying the Part B premium.
Part-D Deductible and Premium
Health First Rewards Plan (HMO) has a monthly drug premium of $0.00 and a $0.00 drug deductible. This Health First Health Plans, Inc. plan offers a $0.00 Part D Basic Premium that is not below the regional benchmark. This covers the basic prescription benefit only and does not cover enhanced drug benefits such as medical benefits or hospital benefits. The Part D Supplemental Premium is $0.00 this Premium covers any enhanced plan benefits offered by Health First Health Plans, Inc. above and beyond the standard PDP benefits. This can include additional coverage in the gap, lower co-payments and coverage of non-Part D drugs. The Part D Total Premium is $0.00. The Part D Total Premium is the addition of the supplemental and basic premiums for some plans this amount can be lower due to negative basic or supplemental premiums.
Premium Assistance
Depending on your income level you may be eligible for full 75%, 50%, 25% premium assistance. The Health First Rewards Plan (HMO) medicare insurance offers a $0.00 premium obligation if you receive a full low-income subsidy (LIS) assistance. And the payment is $0.00 for 75% low income subsidy $0.00 for 50% and $0.00 for 25%.
Full LIS Premium: | $0.00 |
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75% LIS Premium: | $0.00 |
50% LIS Premium: | $0.00 |
25% LIS Premium: | $0.00 |
Gap Coverage
In 2019 once you and your plan provider have spent $3820 on covered drugs. (combined amount plus your deductible) You will be in the coverage gap. (AKA 'donut hole') You will be required to pay 25% for brand-name drugs and 37% on generic drugs unless your plan offers additional coverage. This Health First Health Plans, Inc. plan does not offer additional coverage through the gap.
Plan Services
Health plan deductible
$0 |
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Emergency care/Urgent care
Emergency | $80 per visit (always covered) |
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Urgent care | $40 per visit (always covered) |
Diagnostic procedures/lab services/imaging
Diagnostic tests and procedures | $35 |
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Lab services | $0 copay |
Diagnostic radiology services (e.g., MRI) | $200 |
Outpatient x-rays | $35 |
Hearing
Hearing exam | $30 |
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Fitting/evaluation | Not covered |
Hearing aids - inner ear | Not covered |
Hearing aids - outer ear | Not covered |
Hearing aids - over the ear | Not covered |
Preventive dental
Oral exam | Not covered |
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Cleaning | Not covered |
Fluoride treatment | Not covered |
Dental x-ray(s) | Not covered |
Comprehensive dental
Non-routine services | Not covered |
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Diagnostic services | Not covered |
Restorative services | Not covered |
Endodontics | Not covered |
Periodontics | Not covered |
Extractions | Not covered |
Prosthodontics, other oral/maxillofacial surgery, other services | Not covered |
Healthfirst Reward Card Program Form Pdf
Vision
Routine eye exam | Not covered |
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Other | Not covered |
Contact lenses | Not covered |
Eyeglasses (frames and lenses) | Not covered |
Eyeglass frames | Not covered |
Eyeglass lenses | Not covered |
Upgrades | Not covered |
Mental health services
Inpatient hospital - psychiatric | $200 per day for days 1 through 7 $0 per day for days 8 through 90 |
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Outpatient group therapy visit with a psychiatrist | $35 |
Outpatient individual therapy visit with a psychiatrist | $35 |
Outpatient group therapy visit | $35 |
Outpatient individual therapy visit | $35 |
Skilled Nursing Facility
$0 per day for days 1 through 20 $150 per day for days 21 through 100 |
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Rehabilitation services
Occupational therapy visit | $20 |
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Physical therapy and speech and language therapy visit | $20 |
Ground ambulance
$225 |
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Other health plan deductibles?
In-Network | No |
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Transportation
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Not covered |
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Foot care (podiatry services)
Foot exams and treatment | $35 |
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Routine foot care | Not covered |
Medical equipment/supplies
Durable medical equipment (e.g., wheelchairs, oxygen) | 20% per item |
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Prosthetics (e.g., braces, artificial limbs) | 20% per item |
Diabetes supplies | 15% per item |
Wellness programs (e.g., fitness, nursing hotline)
Covered |
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Medicare Part B drugs
Chemotherapy | 20% |
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Other Part B drugs | 20% |
Maximum out-of-pocket enrollee responsibility (does not include prescription drugs)
$5,500 In-network |
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Optional supplemental benefits
No |
---|
Additional benefits and/or reduced cost-sharing for enrollees with certain health conditions?
In-Network | No |
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Inpatient hospital coverage
$360 per day for days 1 through 5 $0 per day for days 6 through 90 |
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Outpatient hospital coverage
$300 per visit |
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Doctor visits
Primary | $0 copay |
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Specialist | $35 per visit |
Preventive care
$0 copay |
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Ratings for Health First Rewards Plan (HMO) H1099
2018 Overall Rating |
---|
Part C Summary Rating |
Part D Summary Rating |
Staying Healthy: Screenings, Tests, Vaccines |
Managing Chronic (Long Term) Conditions |
Member Experience with Health Plan |
Complaints and Changes in Plans Performance |
Health Plan Customer Service |
Drug Plan Customer Service |
Complaints and Changes in the Drug Plan |
Member Experience with the Drug Plan |
Drug Safety and Accuracy of Drug Pricing |
Staying Healthy, Screening, Testing, & Vaccines
Total Preventative Rating |
---|
Breast Cancer Screening |
Colorectal Cancer Screening |
Annual Flu Vaccine |
Improving Physical |
Improving Mental Health |
Monitoring Physical Activity |
Adult BMI Assessment |
Managing Chronic And Long Term Care for Older Adults
Total Rating |
---|
SNP Care Management |
Medication Review |
Functional Status Assessment |
Pain Screening |
Osteoporosis Management |
Diabetes Care - Eye Exam |
Diabetes Care - Kidney Disease |
Diabetes Care - Blood Sugar |
Controlling Blood Pressure |
Rheumatoid Arthritis |
Reducing Risk of Falling |
Improving Bladder Control |
Medication Reconciliation |
Plan All-Cause Readmissions |
Statin Therapy |
Member Experience with Health Plan
Total Experience Rating |
---|
Getting Needed Care |
Timely Care and Appointments |
Customer Service |
Health Care Quality |
Rating of Health Plan |
Care Coordination |
Member Complaints and Changes in Health First Rewards Plan (HMO) Plans Performance
Total Rating |
---|
Complaints about Health Plan |
Members Leaving the Plan |
Health Plan Quality Improvement |
Health Plan Customer Service Rating for Health First Rewards Plan (HMO)
Total Customer Service Rating |
---|
Timely Decisions About Appeals |
Reviewing Appeals Decisions |
Call Center, TTY, Foreign Language |
Health First Rewards Plan (HMO) Drug Plan Customer Service ratings
Total Rating |
---|
Call Center, TTY, Foreign Language |
Appeals Auto |
Appeals Upheld |
Ratings For Member Complaints and Changes in the Drug Plans Performance
Total Rating |
---|
Complaints about the Drug Plan |
Members Choosing to Leave the Plan |
Drug Plan Quality Improvement |
Member Experience with the Drug Plan
Total Rating |
---|
Rating of Drug Plan |
Getting Needed Prescription Drugs |
Drug Safety and Accuracy of Drug Pricing
Total Rating |
---|
MPF Price Accuracy |
Drug Adherence for Diabetes Medications |
Drug Adherence for Hypertension (RAS antagonists) |
Drug Adherence for Cholesterol (Statins) |
MTM Program Completion Rate for CMR |
Statin with Diabetes |
Coverage Area for Health First Rewards Plan (HMO)
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Source: CMS.
Data as of September 2, 2018.
Star Rating as of October 10, 2018.
For More Information on Ratings Please See the CMS Tech Notes.
Notes: Data are subject to change as contracts are finalized. For 2019, enhanced alternative may offer additional cost sharing reductions in the gap on a sub-set of the formulary drugs, beyond the standard Part D benefit.Includes 2019 approved contracts. Employer sponsored 800 series and plans under sanction are excluded.
Data as of September 2, 2018.
Star Rating as of October 10, 2018.
For More Information on Ratings Please See the CMS Tech Notes.
Notes: Data are subject to change as contracts are finalized. For 2019, enhanced alternative may offer additional cost sharing reductions in the gap on a sub-set of the formulary drugs, beyond the standard Part D benefit.Includes 2019 approved contracts. Employer sponsored 800 series and plans under sanction are excluded.
Keeping Families Healthy
CHPW members can get rewards for checkups through our ChildrenFirst Program. Expecting mothers getting prenatal care can get a $65 online gift card for a car seat. Families can get a $20 online gift card every time a child gets their well child checkup. Prenatal care and regular doctor visits throughout childhood are the foundation for life-long health.
Ready to become a CHPW member?
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We are available to take your calls Monday through Friday, from 8:00 a.m. to 5:00 p.m.
Healthfirst Rewards Program
ChildrenFirst Programs
Prenatal Program: Car seats for new parents
Our Prenatal Program is for CHPW members who are pregnant. To be eligible, you must have gotten two prenatal checkups as a CHPW member. The program offers a $65 online gift card that can be used to buy a car seat.
Well Child Program: Gift cards for every checkup
Download VIA Envy24 Audio Controller Family Driver 5.40a for .... Our Well Child Program is for kids who are CHPW members. To be eligible for the reward, the child must complete a well child checkup and have all their recommended vaccinations. The program offers a $20 online gift card for every completed well child checkup.