This plans includes Prescription Drug (Part D) benefits only — Basic (PDP). The Summary of Benefits, Evidence of Coverage, and other information below explain the details about the plan.
The Medicare Program rates all health and prescription drug plans each year, based on a plan's quality and performance. Medicare Plan Ratings help you to know how good a job our plan is doing. You can use this Plan Rating to compare our plan's performance to other plans. View our Stars Rating (Español). Plan performance summary star ratings are assessed each year and may change from one year to the next.
Summary of Benefits — This booklet explains general information about our Essential and Prime options and compares them to original Medicare. It also includes information about premiums, cost sharing, out-of-network coverage, any limitations, and more:
|Basic Summary of Benefits|
Annual Notice of Change (ANOC) — These documents provide detailed information about changed information of the plan:
|Basic Annual Notice of Change|
Evidence of Coverage (EOC) — This documents provides the most detailed information about the plan:
|Basic Evidence of Coverage|
Health First Health Plans is a PDP plan with a Medicare contract. Enrollment in Health First Health Plans depends on contract renewal.
The benefit information provided is a brief summary, not a complete description of benefits. For more information contact the plan. Limitations, co-payments, and restrictions may apply. Benefits, formulary, pharmacy network, provider network, premium and/or copayments/co-insurance may change on January 1 of each year.
Availability of coverage beyond the end of the current contract year is not guaranteed. Members may enroll in these plans only during certain times of the year. Contact Health First Health Plans for more information. Individuals must have both Medicare Part A and Part B to enroll in the plan. You must continue to pay your Medicare Part B premium. Limitations, copayments, and restrictions may apply.
You must use network pharmacies to access your prescription drug benefit, except under non-routine circumstances. Quantity limitations and restrictions may apply.
You may be able to get Extra Help to pay for your prescription drug premiums and costs. To see if you qualify for getting Extra Help, call:
People with limited incomes may qualify for Extra Help to pay for their prescription drug costs. If you qualify, Medicare could pay for up to seventy-five (75) percent or more of drug costs including monthly prescription drug premiums, annual deductibles, and co-insurance. Additionally, those who qualify will not be subject to the coverage gap or a late enrollment penalty. Many people are eligible for these savings and don’t even know it. For more information about this extra help, contact your local Social Security office or call 1-800-MEDICARE (1-800-633-4227), 24 hours per day, 7 days per week. TTY users should call 1-877-486-2048.
You can also contact Social Security or Medicaid to find out your LIS status or level.
Medicare beneficiaries may enroll in Health First Health Plans through the CMS Medicare Online Enrollment Center located at http://www.medicare.gov
This information is available for free in other languages. Please call our customer service number at 1-800-716-7737 (TDD/TTY 1-800-955-8771). From October 1 - February 14, we're available seven days a week from 8 a.m. to 8 p.m. From February 15 - September 30, we're available weekdays from 8 a.m. to 8 p.m. and Saturdays from 8 a.m. to Noon. If you call after hours, please leave a message and your call will be returned the next business day.
Esta información está disponible gratis en otros idiomas. Por favor llame a nuestro número de servicio al cliente al 1.800.716.7737 (TDD / TTY deben llamar al 1.800.955.8771). Desde 1 de octubre - 14 de febrero, estamos disponibles siete días a la semana de 8 a.m.-8 p.m. Desde 15 de febrero - 30 de septiembre, estamos disponibles de lunes a viernes de 8 a.m. a 8 p.m., los sábados de 8 a.m. a 12 meridiano. Si Ud. llama despues de estas horas, por favor, deje un mensaje y su llamada será devuelta el proximo día hábil.
For more information on authorizations, eligibility, enrollment, pharmacies, prescriptions, or any other benefits, please contact Health First Health Plans Customer Service:
Y0089_MP3537 Approved 11/06/2013
Last updated: 10/1/2013