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Medicare Advantage Plan 2024

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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 48 one-way trips to health-related locations per year

  • Vision and Comprehensive and Preventative Dental

  • Member Rewards Program: Earn rewards by keeping your health appointments and participating in wellness activities. Rewards 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.

Plus, NEW for 2024:

  • Flex Card: 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.

  • Worldwide emergency room services. See reimbursement form here.

NationsBenefits

Get Healthy Foods with the MetroPlusHealth Flex Card

Good news, we’ve made eating healthy easier in 2024! All your healthy foods, OTC drugs, and utilities benefits are now available on one card, and you get more of the benefits you need!  Simply use your MetroPlusHealth Flex Card at participating grocers and pharmacies to purchase fruits, vegetables, and other healthy foods.  You can spend up to $155 each month*.

Some of the places you can use your benefits include CVS, Duane Reade, and Rite Aid. Visit the Member portal for a full list of retailers.

Talk to us about your Flex Card benefits!

Monday–Friday | 8 am–8 pm (ET)
Saturday | 9 am–5 pm (ET)
Call us at 866-986-0356 (TTY: 711)

*Unused balances will automatically expire at the end of each month or upon disenrollment from plan.

  • Health bucks are going away in 2024, but the flex card allows you to still purchase healthy foods
  • Many retailers take the card, including [locally common chains]
  • Your card had $155 of benefits per month to pay for healthy food, OTC drugs, utilities and more, all in one place

For a list of stores where you can use your flex card, click the button below.

How do I enroll?

Ready to enroll in a 2024 MetroPlus Advantage Plan (HMO D-SNP)? Call us at 833-965-1526 (TTY:711) now. Our representatives can enroll you by phone!

Please note new benefits above begin on January 1, 2024.

To access more information about your prescription drug benefits click here: https://www.caremark.com/wps/portal. You will be transferred to the CVS Caremark website. Use the information on your MetroPlusHealth Medicare Member ID card to register. Follow the step by step instructions located on the site.

How can I switch?

Switching to a MetroPlus Advantage Plan (HMO D-SNP) is easy. Get in contact with our team and find answers to FAQs here.

Plan Benefits

Pharmacy Notice

Applicable to MetroPlus Advantage Plan (HMO D-SNP) members with full Medicaid benefits

Gym Reimbursement

Fitness Reimbursement: up to $250 every six months for membership to qualifying exercise facilities

Prepackaged Pills 

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 will update, as needed, the MetroPlus Advantage Plan (HMO D-SNP) Summary of Benefits, Evidence of Coverage, and Annual Notice of Changes for 2024 with 2024 Medicare Parts A & B deductibles and coinsurance amounts.

Medicare Provider / Pharmacy Directories

Kings (Brooklyn) and Richmond (Staten Island)

New York (Manhattan)

Evidence of Coverage (EOC)

A detailed explanation of your coverage, what we must do, your rights, and what you must do as a member of our plan.

Annual Notice of Change (ANOC)

A summary of changes to your benefits and costs for the next year. These changes take effect on January 1, 2024.

Low Income Subsidy (LIS) Premium Table

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”.

Health Risk Assessment

HRA can be returned to:
ATTENTION: QM Health Risk Assessment Unit
MetroPlus Health Plan
50 Water Street, 7th Floor
​New York, NY 10004
or by completing our Contact form by clicking here.

Ready to enroll in a 2024 MetroPlus Advantage Plan (HMO D-SNP)? Call us at 833-965-1526 (TTY:711) now. Our representatives can enroll you by phone!

Want to switch to the 2024 MetroPlus Advantage Plan (HMO D-SNP)? Get answers to FAQs and learn more here.

Rights and Responsibilities Upon Disenrollment

Ending your membership in MetroPlusHealth Medicare plans may be voluntary (your own choice) or involuntary (not your own choice).

You can disenroll or change coverage during applicable enrollment periods. The process for voluntarily ending your membership varies depending on what type of new coverage you are choosing. Your membership will usually end on the first of the month after we receive your request to change your plan.

How do you end your membership in our plan?

Usually, you end your membership by enrolling in another plan. However, if you want to switch from our plan to Original Medicare but you have not selected a separate Medicare prescription drug plan, you must ask to be disenrolled.

  • You can make a request in writing to us or complete this form (link coming soon) and mail it to us.
  • Or, you can contact Medicare at 1-800-Medicare or 1-800-633-4227, 24 hours a day, 7 days a week. TTY users should call 1-877-486-2048. For more information, review your EOC.

If you have any questions, please call Member Services at 833-965-1526 (TTY: 711), 24 hours a day, 7 days a week.

MetroPlus Health Plan, Inc. is an HMO, HMO D-SNP plan with a Medicare contract. MetroPlus Health Plan, Inc. has a contract with New York State Medicaid for MetroPlus UltraCare (HMO D-SNP) and a Coordination of Benefits Agreement with the New York State Department of Health for the MetroPlus Advantage Plan (HMO D-SNP). MetroPlusHealth is not affiliated with, endorsed by, or otherwise related to the federal government, CMS, HHS, and/or Medicare. Enrollment in MetroPlus Health Plan, Inc. depends on contract renewal.
MetroPlus Health Plan, Inc. complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex.
ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de asistencia lingü.stica. Llame al 866.986.0356 (TTY: 711).
注意:如果您使用繁體中文,您可以免費獲得語言援助服務。請致電 866.986.0356 (TTY: 711).

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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.

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.

IMPORTANT INFORMATION: MONKEYPOX CASES ARE RISING IN NYC.

Monkeypox cases are rising in NYC. Learn more about Monkeypox, including prevention and treatment, here.

Explore all MetroPlusHealth Plans

last updated: October 19, 2023

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