Mount Sinai and Healthfirst® Announce Innovative Medicare Advantage Insurance Plan Designed by a Health System for Patients in New York City
The Mount Sinai Health System and Healthfirst today announced the establishment of a new Medicare Advantage plan for Manhattan residents to be co-sponsored by a health system and a Medicare insurer.
The Mount Sinai Health System and Healthfirst today announced the establishment of a new Medicare Advantage plan for Manhattan residents to be co-sponsored by a health system and a Medicare insurer. The Healthfirst Mount Sinai Select (HMO) plan, like other Medicare Advantage (MA) plans, 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 partner with Healthfirst in providing this new, innovative model of care,” said Kenneth L. Davis, MD, CEO and President of the Mount Sinai Health System. “This plan gives members affordable and exclusive access to Mount Sinai’s top-rated network of doctors and specialists.”
The Healthfirst Mount Sinai Select (HMO) differs from other Medicare Advantage plans in that the majority of physicians within the Mount Sinai community will participate and be available within the network. Healthfirst Mount Sinai Select (HMO) offers a tiered network of hospitals and physicians. Members who access care through the preferred Tier 1 Mount Sinai Health System will pay lower cost shares. Beneficiaries will also have access to thousands of additional Tier 2 providers in the Healthfirst network. The plan includes all of the traditional Medicare benefits and in addition, offers coverage for prescription drugs, dental care, hearing aids, acupuncture and eye wear. No copayments are charged for visits with a Tier 1 Preferred Primary Care Physician, an annual routine eye exam or for any Medicare covered preventive services such as mammograms or prostate screenings. Other benefits include up to 12 round trips per year (three round trips, every three months) of no-cost car service to and from doctors’ appointments.
“Healthfirst is very pleased to be at the forefront of provider-payer collaboration through this innovative partnership with Mount Sinai, one of the finest health care systems in the world,” said Pat Wang, Chief Executive Officer of Healthfirst. “Our partnership will blend the best elements of our well-established Medicare Advantage plan infrastructure with the outstanding innovation and clinical excellence of the Sinai system to create a cost-efficient, superb new offering for Medicare members.”
The offering of Healthfirst Mount Sinai Select (HMO) coincides with national trends involving shifting of traditional roles between providers and insurers. More and more, providers are embracing the challenge of higher quality, lower cost, and greater access.
Manhattan residents, who meet the eligibility requirements, can enroll between October 15th and December 7, 2014, for coverage effective January 1, 2015.
Healthfirst is recognized as a leading managed care organization serving more than one million members in downstate New York. Created in 1993 through an innovative consortium of some of the most prestigious and nationally recognized hospitals and medical centers in New York, Healthfirst’s unique model is focused on education, awareness, prevention, and care management. We do this through close collaboration with community organizations, as well as our 24,000 providers and hospital partnerships.
Healthfirst offers a comprehensive selection of free and low-cost health insurance options for individuals and families at every stage of life, including government-sponsored health plans such as Child Health Plus, Medicaid Managed Care, Medicare Advantage, Managed Long Term Care, as well as commercial plans, such as Healthfirst Leaf Plans. We treat our members with the same care and attention we give our own families.
For more information on Healthfirst, visit www.healthfirst.org.
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 7,100 primary and specialty care physicians; 12 joint-venture 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. The Mount Sinai Hospital is in the "Honor Roll" of best hospitals in America, ranked No. 15 nationally in the 2016-2017 "Best Hospitals" issue of U.S. News & World Report. The Mount Sinai Hospital is also ranked as one of the nation's top 20 hospitals in Geriatrics, Gastroenterology/GI Surgery, Cardiology/Heart Surgery, Diabetes/Endocrinology, Nephrology, Neurology/Neurosurgery, and Ear, Nose & Throat, and is in the top 50 in four other specialties. New York Eye and Ear Infirmary of Mount Sinai is ranked No. 10 nationally for Ophthalmology, while Mount Sinai Beth Israel, Mount Sinai St. Luke's, and Mount Sinai West are ranked regionally. Mount Sinai's Kravis Children's Hospital is ranked in seven out of ten pediatric specialties by U.S. News & World Report in "Best Children's Hospitals."