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Stay Covered!

You must renew your plan once a year during the Open Enrollment Period to use your benefits without interruption.

Here’s what you need to know for 2025 Open Enrollment:

1. During Open Enrollment, you can renew or change your plan online with New York State of Health at https://nystateofhealth.ny.gov/.
2. To maintain your coverage for January 2025 complete your renewal by 12/15/2024.
3. Enhanced Tax Credits You might get more financial help due to the American Rescue Plan and Inflation Reduction Act

We’re here to help!

1. You can email us at [email protected] for any questions.

USEFUL LINKS

• MetroPlusHealth Member Portal
• New York State Of Health
• NYSOH Enrollees (American Rescue Plan)

GREAT NEWS! Advance Premium Tax Credits (APTC) are available to people who enroll through the NY State of Health, the state’s health plan marketplace.

What could this mean for you?

• Tax credits are available to people with higher incomes, and people who are unemployed for one week or more in 2021 are now eligible for significant tax credits.
• This means you may be able to pay less for one of the most comprehensive health plans in town!

How can you find out if you can save money on your health plan now?

• Call MetroPlusHealth at 1-855-809-4073, option 3, or Click here to choose a MetroPlusHealth representative who can help explain how these new tax credits may benefit you.

We are here to ensure you get the best health plan for the best price possible.
You can also call 1-855-355-5777 or  visit the NY State of Health website here for more details.

Exclusively for our Marketplace members! Discover the Meditation benefit for mental wellbeing with “The Art of Living” Journey App.

MetroPlusHealth Marketplace QHP members are eligible for a FREE three (3) month membership to a meditation program through the “Art of Living” Journey app. The Journey app provides access to multiple guided meditation modules focused on your specific needs, including sleep, contentment, and calm. Members and their covered dependent(s) can sign up for the new meditation benefit.

Learn more here about the Journey app and what it offers you.

To sign-up, email at [email protected]. We will provide you with a code used to access the online app.

For a step-by-step guide to signing up, click here.

Earn rewards by keeping your health appointments and participating in wellness activities. Rewards can be exchanged with the MetroPlus Rewards Card. Click here to see our member rewards program.

All MetroPlusHealth Marketplace members have access to a mail order option for their medications. Access the mail order form here.

Wondering what health care costs when you don’t have health insurance?
LEARN ABOUT HEALTH CARE COSTS AND MORE HERE

Beginning January 1st, 2025, MetroPlusHealth’s Qualified Health Plan (QHP), Essential Plan (EP), Gold & GoldCare members will now have access to coverage for Human Donor Milk in Outpatient Settings. Coverage for Pasteurized Donor Human Milk (PDHM) includes milk with medically necessary fortifiers. Only a licensed medical practitioner may order the milk. Furthermore, specific clinical criteria for the mother or infant must be met for coverage including:

• Infants weighing < 1500 g, those with a high risk for developing necrotizing enterocolitis, or have a congenital or acquire condition necessitating donor milk.
• Mothers unable to produce any or inadequate amounts or milk, those lacking lactation support, among others.

Beginning January 1st, 2025, MetroPlusHealth’s Qualified Health Plan (QHP), Essential Plan (EP), Child Health Plus (CHP), Gold & GoldCare members will now receive coverage for nipple-areolar tattooing as part of breast cancer reconstruction surgery. Tattooing must be done by a licensed physician or other health care provider and can be done during or after breast reconstruction surgery.

Beginning January 1st, 2025, MetroPlusHealth’s Qualified Health Plan (QHP), Essential Plan (EP), Gold & GoldCare (applicable only to members with Pharmacy Rider) members will have coverage for prenatal vitamins in the same way other similar supplements are covered. These prenatal vitamins may be subject to out-of-pocket costs (i.e. deductible, copays, coinsurance). The vitamins will be covered only when prescribed by a licensed and/or certified practitioner.