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Healthfirst 2020 NY Health Insurance Review – Rates, Forms, Doctors & Benefits

This article is about our review for Healthfirst Group Health Insurance, it contains the comprehensive information of the plans pro & cons, specific Plan Information, how to Make Payment online or over the phone, it’s Frequently Used Forms, links to locate or Find a Doctor and many more.

Healthfirst Insurance Review – 2020 & Beyond

Click Here For Chinese Version 點擊此處閱讀中文版


You probably found us on Google by searching “Is HealthFirst good?”

However, we are here to answer, rather, is it this company the right fit for you?

Headfirst Insurance complete reviews. Is it right for you? Evaluate Doctors networks, Urgent Care Center, Doctors Networks, Payment links, CSR & many more insider tips.

First of all, how are we qualified to provide reviews for you in reference to Healthfirst Insurance? We are one of the brokers that started marketing them since the beginning of their commercial insurance launch.

We had gotten swamped with people calling us up asking us about, is this insurance company good & we are educating people about, rather how to determine if this insurance company is right for you.

Writing a comprehensive article and making a YouTube video covering all these materials is our hope of a more efficient way of doing our job.

That way, if you woke up at 2 am in the morning and feel like looking for an answer, hopefully, this page & our yet to be recorded video will serve you well.

As I said earlier, we are one of the early adopters to share Healthfirst insurance with our community.

Hence, our review may be “Biased“.

We are a broker that represents most insurance carriers located in NY, from UHC, Empire BCBS, Healthfirst & many other.


We got compensated for helping New Yorkers & beyond to address their insurance needs. Hence, our royalty is towards our clients.

As we can recommend any insurance plan that is suitable for our client, – YOU and no matter which insurance plan you choose, the premium you pay is the same, whether you use us or not.

The following is a screen capture from our broker portal.

An insurance broker will be compensated around 3-4% of your total insurance premiums. Again, your monthly premiums will be the same regardless if you use a broker or not.

Healthfirst Health Insurance Rate 2020

In 2020 Healthfirst, you can pay 5% less for Health Insurance!

Healthfirst 2020 Underwriting

It’s an abbreviated version of our full underwriting guidelines that lets you easily look up key elements of our plans, including:

  • Accepted tax forms
  • Renewal deadline/requirements
  • Enrollment/termination rules
  • Audit requirements
  • Member add/term billing rules
  • And more


Click for 2020 Underwriting Guidelines Quick Reference Guide (PDF)

HealthFirst First Health or Health First???

Look out for the leaf. Their correct spelling is Healthfirst.

Click below to learn more about First Health Cofinity Click below to learn more about Health First Healthfirst (the company that we are talking about here has a “leaf” in their logo).

Hence, the plan they offered is called the Leaf Qualified Health Plans. There are 3 similar companies out there with something like Health First, First Health or something like that. The proper name of this company is actually Healthfirst, without space in between.

The background of the company & why it matters to you?

HF-Is-medicaid-Initially-Medicaid -Provider

HF-Is-medicaid-Initially-Medicaid -Provider

For most people, if you just type Healthfirst into a Google search bar, you will see that the first thing Google suggested is, about their Medicaid plan, as Healthfirst, is original, a Medicaid provider. 

Healthfirst Medicaid & Essential Plan which we don’t represent…

I am sorry to inform you that, Healthfirst may be a very good Medicaid & Essential plan provider, but, it is not something we have the right to represent, so I can only ask you to click on the link about to find more about the plan yourself. The company has grown about 5 fold in terms of membership count to 1.2 million members in downstate New York since their CEO Pat Wang told the helm from 2008.

Healthfirst Plan Highlights

All Plans of Healthfirst

Healthfirst 2020 SBC

Platinum Pro EPO

Gold Pro EPO

Gold 20/50/0 Pro EPO

Silver Pro EPO

Silver 40/75/4700 Pro EPO

Bronze Pro EPO

Bronze Pro 6650 EPO

Bronze Pro 8150 EPO

Healthfirst is not suitable for …

Healthfirst network is limited to NY downstate & Nassau County. .i.e. The 5 Boroughs, like Manhattan, Brooklyn, Queens, Bronx & Staten Island plus Nassau County.

Healthfirst service center… (Click)

Healthfirst is well known in offering Medicaid, Child Health Plus, and Managed Long Term Care aka Medicare/Medicaid plans.

It is traditionally a strong player in the low-income market. Healthfirst has expanded to Nassau county through partnering with Greatneck based Northwell Health, or what used to be known as NSLIJ.

Chinatown Locations, Harlem?

Does the Healthfirst service center location scream immigrants to you? It does. they are traditionally a very strong player in the lower-income segment.

In fact, there are very well known in the Medicaid & Medicare/Medicaid plans to offer. In fact, being 5 stars in Medicare Healthfirst started from Medicaid managed care & eventually expanded to Medicare and has been getting rave reviews from doctors & even users alike.

Since about 2 years ago, there have started also selling full-price commercial insurance for groups.

Their commercial group plan offering is relatively new.

Healthfirst started offering commercial plans starting in 2017. I have met many clients who didn’t know about this. The plans offered are Healthfirst Pro and Pro Plus, Exclusive Provider Organization (EPO) plans for small-business owners and their employees, and Healthfirst Total, an EPO for individuals.

Healthfirst’s Pro & Con.

The pro is, if you are an immigrant, Healthfirst is very immigrant-friendly with many doctors speaking a second language.

Healthfirst Pro.  Healthfirst is NY minority population preferred insurance provider?

If you don’t know, the majority of the NY population is the minority. So Healthfirst is as famous as Metro Plus, which is an insurance company specializing in low-income insurance.

As I recalled, we also started selling their commercial insurance 2-3 years ago.

After CEO Pat Wang took office (2008-2018, he also an immigrant), the company’s business grew five times.
You can see Healthfirst service is getting worse and worse (Five-star rate is 1-2 years before).
Maybe it is because most of their clients are individual or just walking in or contact them via phone, and the staffs are lack of experience, so they did not give the customer satisfaction service.
We searched & was very surprised to find out that there are no Japanese Doctor within the Zip Code, while we can get 11 pages of Japanese Doctor by searching another carrier doctor
Healthfirst has a very good relationship with doctors. From what I know, So doctors like this company. But policies often change.
So even if the clients convert the insurance company, they still need us. Because we are the bridge between clients and the insurance company.
I believe that most of you who read these articles are interested in an individual health plan. Perhaps most people don’t know Healthfirst also selling the group health plan.
Just like a restaurant, when it is just opened, both the service and the product are good, but after a long time, the quality may be difficult to guarantee. Just like the group plan of Healthfirst. So far it good, but it is hard to say later. And the above comments are all about the individual plan.

Who is not suitable for Healthfirst

If you want access to the best hospital NY has to offer. (Click below to view Healthfirst complete network, it is somewhat narrow.)
If you are looking for the prestigious Columbia & Cornell are not in networks. These doctors generally only accept PPO insurance plans from those PPO carriers, like Aetna, Cigna, Empire BCBS & Oxford/UHC.

HF’s Doctor Networks & Urgent Care (need to record a video)

VIDEO Pending, in the meantime, this is our Youtube Channel

Healthfirst review

Let’s review Healthfirst from three places:

1st: BBB Reviews


Rating from BBB itself is #BS (click to read why BBB is BS). You really need to read the real user reviews, it wasn’t good really due to the fact that those are review left from people mostly on their Medicaid, Medicare or Dual Plans.

As I mentioned earlier, HealthFirst was a traditional Medicaid provider. Hence, it is uncommon for the employee to not treat their clients on Medicaid with full respect.

However, that is beyond what I can say. From many of my clients who have been on the plans for about 2 years now, there are very happy with their treatment and reimbursement issue.

2nd: Yelp reviews

Yelp reviews also have been around for a good while, hence, many or most of their negative reviews are also from their legacy Medicaid, Medicare & Dual product lines.
The 2019 review we are providing here for their Group plan, hence, wait for it, for our final review in the end.

Yelp’s review does bring up a very valid point. Healthfirst has been expanding so quickly and in fact, just this last week, we have a meeting with Healthfirst management and was being told that there are upgrading the system backend. Hence… see below. (See a screen capture from our interaction with Healthfirst)
Our Client Dr. Yu, who is one of our Heallthfirst Groupp plan client that has been been using their plan for a while told us that one of the employee is missing from the group renew list.

Our Client Dr. Yu, one of our Healthfirst Group plan client told us that one of the employees is missing from the group renew list.

I do foresee technical error to plague them for a little while longer. Do bookmark this page so that you will receive the most current updates.
For complete reviews of Healthfirst from Yelp, click on the link below

3. Google Reviews

Last but not least, Google My Business review. Click below to get an understanding of how Google’s doing review services. Google base their review on each local office. Hence, when you click on the link above, you will see there are varying reviews from better to worst. We took the review from Healthfirst Corp Office.



Healthfirst Infertility Treatment

We Cover services for the diagnosis and treatment (surgical and medical) of infertility when such infertility is the result of malformation, disease or dysfunction. Such Coverage is available as follows:

1. Basic Infertility Services. Basic infertility services will be provided to a Member who is an appropriate candidate for infertility treatment.

In order to determine eligibility, We will use guidelines established by the American College of Obstetricians and Gynecologists, the American Society for Reproductive Medicine, and the State of New York.

However, Members must be between the ages of 21 and 44 (inclusive) in order to be considered a candidate for these services.

Basic infertility services include:

• Initial evaluation;

• Semen analysis;

• Laboratory evaluation;

• Evaluation of ovulatory function;

• Postcoital test;

• Endometrial biopsy;

• Pelvic ultrasound;

• Hysterosalpingogram;

• Sono-histogram;

• Testis biopsy;

• Blood tests; and

• Medically appropriate treatment of ovulatory dysfunction.

Additional tests may be Covered if the tests are determined to be Medically Necessary.

2. Comprehensive Infertility Services. If the basic infertility services do not result in increased fertility, We Cover comprehensive infertility services.

Comprehensive infertility services include:

• Ovulation induction and monitoring;

• Pelvic ultrasound;

• Artificial insemination;

• Hysteroscopy;

• Laparoscopy; and

• Laparotomy.

3. Exclusions and Limitations. We do not cover:

• In vitro fertilization, gamete intrafallopian tube transfers or zygote intrafallopian tube transfers;

• Costs for an ovum donor or donor sperm;

• Sperm storage costs;

• Cryopreservation and storage of embryos;

• Ovulation predictor kits;

• Reversal of tubal ligations;

• Reversal of vasectomies;

• Costs for and relating to surrogate motherhood (maternity services are Covered for Members acting as surrogate mothers);

• Cloning; or

• Medical and surgical procedures that are experimental or investigational, unless Our denial is overturned by an External Appeal Agent.

All services must be provided by Providers who are qualified to provide such services in accordance with the guidelines established and adopted by the American Society for Reproductive Medicine.

L. Infusion Therapy.

We Cover infusion therapy which is the administration of drugs using specialized delivery systems that otherwise would have required You to be hospitalized.

Drugs or nutrients administered directly into the veins are considered infusion therapy. Drugs taken by mouth or self-injected are not considered infusion therapy.

The services must be ordered by a physician or other authorized Health Care Professional and provided in an office or by an agency licensed or certified to provide infusion therapy. Any visits for home infusion therapy count toward Your home health care visit limit.

Healthfirst Acupuncture and Physical Therapy

Acupuncture: unlimited and no deductible

Physical Therapy is 60 visits as indicated on all of our small group plan Summary Benefit Coverage.

Please click the button below for more information about:

Healthfirst Login

Healthfirst Pay Online (Please call Healthfirst to access your Online Payment Account)

Pay By Phone (It can be done by calling Employer Service): Call 1-855-949-3668 to pay over the phone directly

Or you can mail the check to :

Healthfirst Insurance Company
PO Box 13831
Philadelphia, PA 19101-3831

Reviews of Oxford/UHC, Empire BCBS, Healthfirst, Emblem, Oscar

We are combining Public reviews from Google GMB (Google my business), BBB (Better Business Bureau), Public review from Yelp & our Broker insider insights to give you the single most comprehensive unbiased review.

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