Medicare Advantage Plan 2023
When you choose MetroPlus Advantage Plan (HMO D-SNP), you get one of the most complete health plans in New York City. If you are eligible for Medicare and Medicaid, you’ll receive all of your current benefits, plus much more.
To be eligible for our MetroPlus Advantage Plan (HMO D-SNP), you must have Medicare Part A, be enrolled in Medicare Part B, eligible for Medicaid or Medicare cost-sharing assistance under Medicaid, and live in New York City.
MetroPlus Advantage Plan (HMO D-SNP) provides all the benefits of Original Medicare PLUS:
Telehealth: Free 24/7 virtual access to doctors and therapists from your smart phone, tablet or computer
Routine Transportation: $0 copay for up to 14 one-way trips to health-related locations per year
Vision and Comprehensive and Preventative Dental
Member Rewards Program: Earn points by keeping your health appointments and participating in wellness activities. Points can be exchanged for items from our exclusive catalog
Medications pre-packaged and delivered to you at no extra cost. Available through PillPack or CVS Pharmacy. Learn more below.
Healthy food vouchers: Qualifying members may get up to $100 per quarter ($400 per calendar year) in food vouchers for purchasing fresh, healthy fruits and vegetables from participating vendors. For a list of 2023 year-round food access sites across New York City, link coming soon.
Over the Counter (OTC) benefit: Members receive $375 per quarter ($1500 per calendar year) for purchase of OTC items (approved non-prescription drugs and health-related items). Learn more below.
How do I enroll?
Plus new for 2023:
Flex Card: Get a pre-paid $400 debit card annually to use toward home/bathroom safety devices and modifications, utilities, cable, and phone services. View our catalog in the Plan Benefits section below or go to members.nationsbenefits.com/metroplus to place your order.
Worldwide emergency room services. See reimbursement form here.
The Inflation Reduction Act (IRA): Changes to Your Drug Coverage
Free or Low-Cost Preventive Health Care Services
At MetroPlusHealth, we always want you to be at your best. That’s why we encourage you and your family to take advantage of preventive care services available to you at low or no cost. We’ve listed dozens of FREE preventive services here for adults, women and children that just may help you be your healthiest yet.
Plan Benefits
Fitness Reimbursement: up to $250 every six months for membership to qualifying exercise facilities
Members will receive a $155 flex card benefit per month that can be used to purchase Over the Counter (OTC) items, groceries, home utilities (water, gas, electricity, internet services), Personal Emergency Response System (PERS), and bathroom safety devices. Unused flex card balance will expire at the end of each month. View our catalog in the Plan Benefits section below or go to members.nationsbenefits.com/metroplus to place your order.
Medications can be pre-packaged and delivered to you at no extra cost. Available through PillPack or CVS Pharmacy. Learn more below.
Plan Materials
MetroPlusHealth has updated the MetroPlus Advantage Plan (HMO D-SNP) Summary of Benefits, Evidence of Coverage, and Annual Notice of Changes for 2023 with 2023 Medicare Parts A & B deductibles and coinsurance amounts. Please review the updated documents for more information.
A detailed explanation of your coverage, what we must do, your rights, and what you must do as a member of our plan.
A summary of changes to your benefits and costs for the next year. These changes take effect on January 1, 2023.
Low Income Subsidy is available under the Medicare Part D prescription drug program. Eligible beneficiaries who have limited income may qualify for a government program that helps pay for Medicare Part D prescription drug costs. If you receive “Extra Help” from Medicare, your monthly plan premium will be lower. The Low Income Subsidy (LIS) Premium Table shows you what your monthly premium will be if you get “Extra Help”.
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.
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
