What Does MetroPlus Medicaid Cover? A Full Benefits Breakdown
If you live in New York City and qualify for Medicaid, MetroPlusHealth’s Medicaid Managed Care Plan offers a wide range of free Medicaid benefits in NY — with no monthly bill and no copays.
$0 monthly premiums and copays
One of the biggest perks of MetroPlusHealth’s Medicaid Managed Care plan is the cost — which is nothing. Members pay $0 monthly premiums and copays, meaning there’s no bill to worry about just to have coverage, and no fees every time you see a doctor. You also have access to free non-emergency medical transportation services and even our member rewards program.
What does MetroPlusHealth Medicaid cover?
MetroPlusHealth Medicaid plan covers a wide range of services across all five boroughs of New York City, including:
- Regular check-ups and office visits with your own primary care provider
- Specialist care
- Hospital care (inpatient and outpatient)
- Emergency visits (No surprise bills…ever!)
- Dental care
- Vision and hearing exams
- Lab tests and X-rays
- Behavioral health and mental health services
- Family planning
- Prenatal care for expecting mothers
- Well-baby and well-child care visits
- Prescriptions
One important benefit: you get to choose your own primary care doctor. You’re not locked into whoever is available. Pick the provider that works best for you and your family.
Free transportation to medical appointments
Getting to your appointments shouldn’t be a barrier to care. That’s why MetroPlusHealth Medicaid members are eligible for free transportation to non-emergency medical visits. This benefit helps reduce the stress of getting to medical appointments on time, without having to rely on family or friends. This is a covered benefit for eligible members — another example of the free Medicaid benefits in NY that make a real difference in everyday life.
Does Medicaid offer mental health resources?
Absolutely. Medicaid is required to offer mental health coverage. This includes access to behavioral health services, psychiatric services, inpatient and outpatient mental health treatment, and more.
Member rewards for staying healthy
No matter what kind of health insurance you have, MetroPlusHealth encourages all members to take care of themselves through our member rewards program. From getting annual checkups to getting eligible screenings, Medicaid members can earn rewards to spend at participating retailers. It’s a simple way to get something back while taking care of your health.
Who is eligible for MetroPlusHealth Medicaid?
You may qualify if you:
- Live in New York
- Meet specific income requirements
- Receive Supplemental Security Income (SSI)
- Have high medical bills
- Have certain age needs
- Have certain disability needs
Not sure if you qualify? MetroPlusHealth can help you check your eligibility before you apply.
How do I enroll?
MetroPlusHealth’s Medicaid Managed Care is open for enrollment year-round so you can sign up anytime. Learn more about our program and how to enroll using one of the following options:
- Access NY State of Health online or by phone at 1-855-355-5777
- Medicaid Helpline – 1-800-541-2831
- Access Local Departments of Social Services online