Mount Sinai and Healthfirst® Re-Enter Open Enrollment Season for Medicare Beneficiaries in New York City
The Mount Sinai Health System and Healthfirst are, for the second year, participating in the Medicare Open Enrollment season with their co-branded Medicare Advantage plan for Manhattan residents, the Healthfirst Mount Sinai Select (HMO) plan. Like other Medicare Advantage (MA) plans, Healthfirst Mount Sinai Select is an alternative to the traditional Medicare program and allows Medicare beneficiaries to secure private insurance coverage financed by the federal government.
“We are very proud to offer the Manhattan community an innovative model of care,” said Kenneth L. Davis, MD, President and Chief Executive Officer of the Mount Sinai Health System. “This plan gives members affordable and exclusive access to Mount Sinai’s top-rated network of doctors, specialists, and hospitals.”
Healthfirst Mount Sinai Select (HMO) differs from other Medicare Advantage plans in that the majority of Mount Sinai physicians and all seven Mount Sinai-affiliated hospitals are available as Tier 1 preferred providers. This means that members who access care through Mount Sinai Health System Tier 1 providers will pay lower cost shares. No copayments are charged for visits with a Tier 1 Preferred Mount Sinai-affiliated Primary Care Physician, for annual routine eye exams, or for any Medicare-covered preventive services such as mammograms or prostate screenings. Beneficiaries will also have access to thousands of additional Tier 2 providers in the Healthfirst network with higher cost shares.
In addition to traditional Medicare benefits, Healthfirst Mount Sinai Select (HMO) also offers coverage for Part D prescription drugs, dental care, hearing aids, acupuncture, and eye wear. Other benefits include free transportation (up to12 round trip car service rides each year) to and from doctor appointments.
The offering of the Healthfirst Mount Sinai Select (HMO) plan coincides with national trends involving the shifting of traditional roles between providers and insurers. More and more, providers are embracing the challenge of higher quality, lower cost, and greater access.
“Healthfirst is very pleased to be at the forefront of innovative provider-payer collaboration through this continuing partnership with Mount Sinai, one of the world’s most-respected healthcare systems,” said Pat Wang, Chief Executive Officer of Healthfirst. “Healthfirst has built extremely integrated partnerships with the provider community that would be difficult to achieve under a typical contracting relationship. By working closely with providers like Mount Sinai, we can get closer to the members and their communities to improve quality and member satisfaction.”
Manhattan residents who meet the eligibility requirements can enroll between October 15 and December 7, 2015, for coverage effective January 1, 2016.
About the Mount Sinai Health System
The Mount Sinai Health System is an integrated health system committed to providing distinguished care, conducting transformative research, and advancing biomedical education. Structured around seven hospital campuses and a single medical school, the Health System has an extensive ambulatory network and a range of inpatient and outpatient services—from community-based facilities to tertiary and quaternary care.
The System includes approximately 6,100 primary and specialty care physicians; 12 minority-owned free-standing ambulatory surgery centers; more than 140 ambulatory practices throughout the five boroughs of New York City, Westchester, Long Island, and Florida; and 31 affiliated community health centers. Physicians are affiliated with the renowned Icahn School of Medicine at Mount Sinai, which is ranked among the highest in the nation in National Institutes of Health funding per investigator. Seven departments at The Mount Sinai Hospital and one at the New York Eye and Ear Infirmary (NYEE) ranked nationally in the top 25 in the 2015-2016 “Best Hospitals” issue of U.S. News & World Report. Mount Sinai’s Kravis Children’s Hospital is also ranked in seven out of ten pediatric specialties by U.S. News & World Report.
Healthfirst® is a not-for-profit health insurance company sponsored by some of the most prestigious hospitals and healthcare systems in New York. It serves close to 1.2 million members in New York City and in Long Island through government-sponsored programs including Child Health Plus, Medicaid, Medicare Advantage, and Managed Long Term Care, as well as through private health plans including Healthfirst Leaf and Qualified Health Plans, offered on NY State of Health, The Official Health Plan Marketplace.
Established in 1993, Healthfirst was an early pioneer in aligning incentives and goals with the provider delivery system through comprehensive value-based payment approaches. Today, with its provider partners, it is at the forefront of healthcare reform as it continues to build upon its collaborative model to offer the best in quality and member-centric care. It is a 4-Star Medicare Advantage plan for the second year in a row and the only health plan in its market with 5 Stars for quality on the NY State of Health.
For more information on Healthfirst, visit www.healthfirst.org.