ExchangeCoverageHigh impact
Diabetes Cost-Sharing Reduction for Essential Plan, Leaf Plan, and Leaf Premier Plan Members
Healthfirst·Endocrinology, Family Medicine, Internal Medicine +2 more·Provider Update
We identified it
Jun 20, 2026
Summary
Healthfirst members with Essential Plan, Leaf Plan, and Leaf Premier Plan will have $0 out-of-pocket costs for all diabetes-related care including medical services, prescription drugs, insulin, supplies and diagnostics. This eliminates all deductibles, copays, and coinsurance for in-network diabetes services.
Action Required
Immediately: Update billing system to set $0 patient responsibility for all diabetes-related services for Healthfirst Essential Plan, Leaf Plan, and Leaf Premier Plan members. Train front desk staff to verify member plan type and not collect copays/deductibles for eligible diabetes services. Update patient statements to reflect $0 cost-sharing for these specific plans.