Healthfirst Signature (HMO)

Healthfirst Signature (HMO) is a HMO plan offered by Healthfirst, Inc. available for enrollment in 2025 to people living in New York City and Nassau County. This plan received an overall rating of 3.5 out of 5 stars in 2026.

It's important to know that Healthfirst Signature (HMO) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.

Key Plan Facts

Below are a few key facts and commonly-asked questions about Healthfirst Signature (HMO).

Plan Costs:

The cost of a Medicare Advantage Plan is made up of four main parts.

• First, the monthly premium — the amount you pay every month.
• Second, the deductible — the amount you pay out of pocket for covered services before the plan starts paying.
• Third, the copayments and coinsurance — the amounts you pay out of pocket for covered services, usually after meeting the deductible (if applicable). Copays are fixed dollar amounts; coinsurance is a percentage of the cost.
• Fourth, the Out-of-Pocket Maximum — the maximum amount you could have to pay out of pocket in a year. This may be different for in-network and out-of-network services.

You can see below for the coinsurance and specific copayments for in the Additional Benefits section below, or refer to our Plan Details page for more details.

Common Services:

Drug Coverage

The Healthfirst Signature (HMO) Medicare prescription drug plan features an annual drug deductible of $615. For Tier 1 preferred generic drugs, you will pay a low copay of $1.00 for a 1-month supply, while Tier 2 generic drugs cost a $2.00 copay for a 1-month supply at standard pharmacies and through standard mail order. Select Care Drugs in Tier 6 are highly affordable, requiring no copay for 1-month, 2-month, or 3-month supplies. For brand-name and specialty medications, the plan transitions to coinsurance rather than flat copays. Tier 3 preferred brand drugs require a 19% coinsurance, while Tier 4 non-preferred drugs and Tier 5 specialty drugs both carry a 25% coinsurance for standard pharmacy and mail order services. These cost-sharing rates apply to standard 1-month, 2-month, and 3-month fills, except for specialty medications which are limited to a 1-month supply.

Additional Benefits

The Healthfirst Signature (HMO) plan offers comprehensive medical coverage, featuring no copay for primary care visits, preventive services, and home health care, while specialist visits require a $40 copay. Inpatient hospital stays require a $611 copay for days 1 to 4 with no copay for additional days, while emergency room visits carry a $115 copay. Outpatient hospital services generally involve a copay and up to 20% coinsurance, whereas diagnostic radiological services feature no copay. For additional wellness needs, the plan provides dental coverage with no copay up to a $1,000 annual maximum and routine vision exams with no copay alongside a $200 eyewear allowance. Routine hearing exams require a $40 copay, while prescription hearing aids are covered with copays ranging from no copay up to $1,475. Durable medical equipment and home infusion services are also covered with no copays, although some equipment may require up to 20% coinsurance.