MetroPlusHealth Gold Plan

To get covered services, you need to see providers in the MetroPlusHealth network. Receiving care from out-of-network doctors or providers is not covered, and you may have to pay for the medical services if you go out of network.

But, if an urgent medical issue happens outside of our service area, you will be completely covered if you go to an emergency room. That’s anywhere nationwide, whether it’s in our network or not.

MetroPlusHealth wants our members to be healthy. Take advantage of our gym and wellness benefit reimbursement program and maximize your results at minimal cost to you. Learn more here.

All MetroPlusHealth Gold members have access to a mail order option for their medications. Access the mail order form here: https://www.caremark.com/portal/asset/mof_unauth.pdf

*Except for emergency room visits which have a $100.00 co-pay (waived if you’re admitted to the hospital) and urgent care visits which have a $25 copay.
**The payout may be considered taxable income, and subject to state and federal taxes in the tax year you get it. We recommend that you consult a professional tax expert with any questions.
***for those who qualify