Use Your Healthfirst OTC Plus Card to the Extreme

Healthfirst Medicare Advantage OTC Card

The Healthfirst Medicare Advantage OTC Plus Card is a valuable resource for members, designed to promote wellness and provide support for everyday health needs. This flexible card allows members to purchase a wide range of over-the-counter items, pay for essential utilities, buy healthy foods, and access fitness-related products, depending on their specific Medicare Advantage plan.


What Is the Healthfirst Medicare Advantage OTC Plus Card?

The OTC Plus Card offered by Healthfirst is loaded with a quarterly allowance—some plans provide up to $575 every quarter. This card helps members stay healthy without spending out of pocket. It can be used to purchase:

  • Non-prescription medicines and wellness products
  • Healthy groceries
  • Home utility services such as electric, gas, internet, and water
  • Activity trackers and fitness gear
  • Personal emergency response systems (PERS)

Members can activate the card easily via phone or online and use it at a variety of retail partners across the region.


Dental Coverage for Members

Healthfirst Medicare Advantage plans include strong dental benefits. Most plans offer preventive dental care, including cleanings and oral exams, as well as more extensive services like crowns, dentures, root canals, and extractions. Some plans provide up to $2,500 annually in comprehensive dental care, supporting both oral health and overall wellness.


Medicaid and Dual Eligibility Integration

Healthfirst also provides special plans for individuals who qualify for both Medicare and Medicaid, often referred to as Dual Eligible Special Needs Plans (D-SNPs). These plans are specifically structured to cover extra services and reduce costs for low-income seniors. Key benefits for dual-eligible members include:

  • $0 prescription drug copays
  • Expanded dental, hearing, and vision services
  • Enhanced OTC Plus Card with higher quarterly allowances
  • Free transportation to medical appointments
  • Access to fitness programs like SilverSneakers

Drug Coverage and Formulary Access

Prescription drug coverage is included in Healthfirst Medicare Advantage plans. Members benefit from access to a comprehensive formulary, which includes:

  • $0 copays on many preferred generic medications
  • Affordable access to both generic and brand-name drugs
  • Delivery options through mail-order pharmacies

Members can consult the plan’s official drug list (formulary) to ensure their medications are covered and to understand tier pricing.


Customer Service and Support

  • Check their OTC balance
  • Request replacement cards
  • Get help with claims and prescriptions
  • Understand benefit eligibility and coverage

Member Portal and Online Login

The Healthfirst member portal gives members 24/7 access to their health plan details. Through the online portal, members can:

  • View OTC Plus Card balances
  • Order eligible items
  • Track previous purchases
  • Find in-network providers and pharmacies

This secure system also allows members to print ID cards, update personal information, and access plan documents conveniently.


Provider Portal for Healthcare Professionals

Healthfirst also supports healthcare providers with an online portal designed to simplify patient management. Providers can:

  • Confirm member eligibility
  • Submit and track claims
  • Check authorizations and referrals
  • Access medical policies and drug formularies

This platform streamlines communication between providers and the health plan to enhance patient care. Click here for provider portal.


Healthfirst’s HMO Plan Model

Most Medicare Advantage plans offered by Healthfirst are HMO (Health Maintenance Organization) plans. These plans require members to select a primary care physician (PCP) and obtain referrals to see specialists. Benefits of this model include:

  • Coordinated, preventive-focused care
  • Lower monthly premiums and out-of-pocket costs
  • Access to a defined network of qualified providers

Some HMO plans also provide direct access to specialists within the network without needing a referral, depending on the specific plan.


Where Healthfirst Medicare Advantage Plans Are Available

As of 2025, Healthfirst Medicare Advantage plans are available in parts of New York State. The following counties and areas are included:

  • Bronx
  • Brooklyn
  • Manhattan
  • Queens
  • Staten Island
  • Nassau
  • Orange
  • Rockland
  • Sullivan
  • Westchester

Currently, Healthfirst does not operate Medicare Advantage plans outside New York, but it remains one of the most trusted providers within the state.

Conclusion

Healthfirst continues to stand out as a comprehensive healthcare provider for Medicare-eligible individuals across New York. Whether you need help with managing medications, accessing routine dental care, using your OTC Plus Card, or understanding dual eligibility, Healthfirst offers a user-friendly system designed for convenience, affordability, and member satisfaction.

For more information or help with your plan, you can log in to the member portal or contact customer service today.

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