The Mount Sinai Health System and Healthfirst, a leading managed care organization serving more than one million members in downstate New York, have launched a unique, co-branded Medicare Advantage (MA) insurance plan for Manhattan residents. Eligible Medicare beneficiaries can enroll in Healthfirst Mount Sinai Select (HMO) between October 15 and December 7, 2014, for coverage effective January 1, 2015.
“Members of the plan will have affordable and exclusive access to Mount Sinai’s top-rated network of doctors and specialists—the majority of whom will participate in the Healthfirst Mount Sinai Select plan,” says Kenneth L. Davis, MD, Chief Executive Officer and President of the Mount Sinai Health System. “Members will not need referrals for most specialist visits.”
Healthfirst Mount Sinai Select (HMO) is approved by the Centers for Medicare & Medicaid Services (CMS) as an alternative to the traditional Medicare program, and allows Medicare beneficiaries to secure private insurance coverage financed by the federal government. In addition to including the traditional Medicare benefits, the plan will provide coverage for prescription drugs, dental care, hearing aids, acupuncture, and eyewear.
According to Dr. Davis, “The Healthfirst Mount Sinai Select plan aligns the Mount Sinai Health System with national trends that are shifting the traditional roles between providers and insurers. It also expands our footprint in the New York marketplace and expands our relationship with Healthfirst, as Mount Sinai is a major owner of the plan.”
Pat Wang, Chief Executive Officer of Healthfirst, says, “We are very pleased to be at the forefront of provider-payer collaboration through this innovative partnership with Mount Sinai. Our partnership will blend the best elements of our well-established Medicare Advantage plan infrastructure with the outstanding innovation and clinical excellence of the Mount Sinai Health System to create a cost-efficient offering for Medicare members.”
“Healthfirst is the highest rated and only 4-Star Medicare Advantage HMO plan* in New York City and has achieved this result, in part, through partnership with the clinical leadership of quality providers like the Mount Sinai Health System,” says Jay Schechtman, MD, MBA, Chief Medical Officer, Healthfirst, and Assistant Clinical Professor, Icahn School of Medicine at Mount Sinai.
The Healthfirst Mount Sinai Select plan offers a Tiered Network:
- Tier 1 includes providers within the Mount Sinai Health System, and offers no or low copayments.
- Tier 2 includes Healthfirst providers outside the Mount Sinai Health System, who are available at a higher copayment.
Members of the Healthfirst Mount Sinai Select plan will not be charged for annual routine eye exams or for any Medicare-covered preventive services, such as mammograms and prostate screenings, and are entitled to 12 round trips per year (three round trips, every three months) of no-cost car service to and from physician appointments.
For more information on the plan, please visit: http://healthfirst.org/health-insurance/2015-medicare-plans/mount-sinai-select/.
Healthfirst Medicare Plan is an HMO plan with a Medicare contract and a contract with the New York Medicaid program. Enrollment in Healthfirst Medicare Plan depends on contract renewal. Other providers are available in our network. The benefit information provided is a brief summary, not a complete description of benefits. For more information, contact the plan. Limitations, copayments, and restrictions may apply. Benefits, formulary, pharmacy network, provider network, premium and/or copayments/co-insurance may change on January 1 of each year.
*Medicare evaluates plans based on a 5-star rating system. Star Ratings are calculated each year and may change from one year to the next. Please visit www.medicare.gov for more information on CMS’ Star Ratings.
H3359_MKT15_41v2 Accepted 10182014