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Marketplace Plans

Know Your Benefits

Marketplace Benefits

The NY State of Health is a health plan marketplace where individuals, families, and small businesses can browse and purchase health insurance online. MetroPlus Health Plan, the plan of choice for half a million New Yorkers, offers Qualified Health Plans- or QHPs – through The NY State of Health Marketplace at an affordable rate for you and your family.

Learn more about the benefits available to you through our Marketplace plans below.

Essential Health Benefits

  1. Outpatient care – the kind you get without being admitted to a hospital
  2. Trips to the emergency room
  3. Treatment in the hospital for inpatient care
  4. Care before and after your baby is born
  5. Mental health and substance use disorder services: This includes behavioral health treatment, counseling, and psychotherapy
  6. Your prescription drugs
  7. Services and devices to help you recover if you are injured, or have a disability or chronic condition. This includes physical and occupational therapy, speech-language pathology, psychiatric rehabilitation, and more.
  8. Your lab tests
  9. Preventive services including counseling, screenings, and vaccines to keep you healthy and care for managing a chronic disease.
  10. Pediatric services: This includes dental care and vision care for kids
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MetroPlusHealth Virtual Visit

Access to a doctor—whenever and wherever you need it!

MetroPlusHealth Virtual Visit is the fast, easy way for our members to see a provider for common physical, mental, emotional, and behavioral health issues that are not emergencies. MetroPlusHealth Virtual Visit is available anytime, from anywhere in New York State, 24/7 – and in your language.

GREAT NEWS: STARTING JANUARY 1, 2023, METROPLUSHEALTH MEMBERS WILL RECEIVE THEIR DENTAL BENEFITS FROM DENTAQUEST.

Recently, we sent you an announcement along with your new ID Card about our new partnership with DentaQuest, a dental vendor. Starting January 1, 2023, you can begin to use your new ID Card for all your health care needs, including dental services with DentaQuest. Remember to bring your new ID card when you visit your dentist.

Your oral health is important to us. Partnering with DentaQuest, we are able to bring their experience and passion for improving oral health care to you. Their dental network is 65% larger than what we have been offering, with more dentists and specialists available than before. Learn more about your new dental benefit here.

Know your rights and protections against surprise medical bills!

When you get emergency care or are treated by an out-of-network provider at an in-network hospital or ambulatory surgical center, you are protected from balance billing. In these cases, you shouldn’t be charged more than your plan’s copayments, coinsurance and/or deductible.

Are you receiving care at an NYC Health + Hospitals facility?

Manage Your Health Online With MyChart. Members who receive care at NYC Health + Hospital facilities now have access to MyChart. MyChart is a free secure portal you can use to manage your health information. MyChart allows you to:

  • Message your primary care provider’s office
  • Request refills of your prescription drugs
  • Access your test results
  • Schedule appointments
Preventive Services Resources

Learn about all of the free preventive services for adults, women and children. Preventive care includes immunizations, physical exams, lab tests and prescriptions. If you have any questions, call one of our Member Services Representatives. We’re here to help.

Explore all MetroPlusHealth Plans

last updated: August 15, 2022

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