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MetroPlusHealth Gold Plan

You take care of New York.
Gold takes care of you.

Designed for NYC employees.

Open Enrollment is Nov. 1-30, 2026 for City of NY employees.

Why choose MetroPlusHealth Gold?

A health plan built by New Yorkers, for New Yorkers.

*No copay for urgent care, effective 1/1/2027. $100 copay for ER waived if admitted.
†Note: This is a drug discount program, not a prescription drug benefit. Drugs on the list are provided to covered individuals at a discounted price of $0 as part of a health and wellness benefit. Coverage for drugs that are not included in the discount program, require purchase of the optional rider and may be subject to copays. List of drugs can be found at metroplus.org/gold-rx-list
^NYC Health + Hospitals specialists may require medical referrals

Who is eligible for Gold Plan?

1

All employees of the City of New York

and their qualified domestic partners and eligible dependents

2

NYC Health + Hospitals employees

and their qualified domestic partners and eligible dependents

3

Non-Medicare eligible retirees

New and Enhanced 2027 Benefits

  • No referrals required for in-network specialist visits*
  • $0 urgent care copays beginning January 1, 2027
  • New doula services for expectant parents, including:
    • Up to eight prenatal or postpartum visits
    • One labor and delivery support visit per pregnancy
  • Prescription Concierge: Help accessing manufacturer copay assistance.
  • More than 100 commonly prescribed medications available at no cost.**
  • Diabetes Support: Expanded access to CGMs and insulin pumps through participating suppliers.
*NYC Health + Hospitals specialists may require medical referrals
**Note: This is a drug discount program, not a prescription drug benefit. Drugs on the list are provided to covered individuals at a discounted price of $0 as part of a health and wellness benefit. Coverage for drugs that are not included in the discount program, require purchase of the optional rider and may be subject to copays. List of drugs can be found at https://metroplus.org/gold-rx-list/

Up to $5,000 in value to keep you healthy

The New Gold Signature Experience

Available to all new and existing Gold members, this enhanced service provides white-glove support to help members navigate their health care journey with ease.

From benefit questions to care coordination and everything in between, we’re making it easier than ever for Gold members to get the support they need, when they need it, how they need it.

Because exceptional service should be part of every member’s experience.  

Plan Benefits

  • $0 copays for primary care provider visits
  • $0 copays for specialist visits
  • $0 per month premium for individuals and families
  • $0 deductible
  • $0 copay for over 125 commonly used prescription drugs
  • $0 telehealth visits – 24/7 access to doctors and therapists
  • Access in-network providers without a referral from your primary care physician.*
  • 26 dietician visits per year at no cost
  • 10 acupuncture visits per year at no cost
  • Up to $60 transportation reimbursement per year
  • Fitness reimbursements

Effective January 1, 2027

  • $0 copay for urgent care
  • Eligible members and their dependents earn up to $250 in rewards by doing heathy activities
  • Doula visits
* NYC Health + Hospitals specialists may require medical referrals

Join thousands of city employees who’ve made the switch.

Open enrollment starts on November 1st.

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Are you a Health + Hospitals employee unsure about how to enroll in the MetroPlusHealth Gold plan?

Just follow the four easy steps.

Pharmacy Network

Convenient access, from neighborhood pharmacies to home delivery.

Major Retail Pharmacies

Broad access across trusted national and regional chains.

  • CVS

    Home delivery available

  • Duane Reade

    Convenient neighborhood access

  • Walgreens

    National retail network

  • Stop & Shop

    Pharmacy access while you shop

More ways to fill prescriptions

Flexible options built around member preference and convenience.

  • Independent pharmacies

    Several hundred community locations

  • Amazon Pharmacy

    Home delivery, including PillPack

  • Capsule Pharmacy

    Free same-day prescription delivery

  • Additional network options

    And many more participating pharmacies

Cost Comparison for Members Who Select the Optional Drug Rider

CoverageMetroPlusHealth GoldComparable NYC PPO PlanComparable NYC HMO PlanYou Save
Individual Coverage
Weekly$26.47$31.22$39.08Up to $12.61/week
Bi-Weekly$52.93$62.45$78.16Up to $25.23/pay period
Semi-Monthly$57.50$67.84$84.91Up to $27.41/pay period
Family Coverage
Weekly$50.63$57.24$73.47Up to $22.84/week
Bi-Weekly$101.26$114.49$146.93Up to $45.67/pay period
Semi-Monthly$110.00$124.37$143.85Up to $33.85/pay period

Frequently asked questions about
the Gold Plan

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Want to learn more about Gold?

Join a free Webinar!

Webinars are offered on the first Wednesday of each month or the last Friday of each month through December 2026.

4+ stars from over 700,000 MetroPlusHealth members

It’s always easy to get in contact with someone when needed. Best insurance I’ve had!

Alicia S.
Google Review

Representative was very professional and helpful, showed empathy for my well being with no attitude …. Thank you….. 😊 👍👍

Betsy J.
Google Review

They’re very helpful and took care of me when I had an emergency 👍🏾👌🏾💯

Mateo V.
Google Review

Personally I’ve always had and still have very great experiences with MetroPlusHealth, I would recommend it to anyone who is looking for the best health insurance services. Thank you MPH for always taking great care of me and mines.

Michaelle J.
Google Review

Thank you. It was super easy to get appt and to be able to speak to my doctor.

Lourdes S.
Google Review

I have been with them for many years and have only good things to say about MetroPlusHealth. They are always helpful, understanding, and working with me.

Ireen S.
Google Review
last updated: October 1, 2026
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