What do I need to enroll?

There are many options for New York City health insurance, but if you work for NYC, you’re eligible for the MetroPlusHealth Gold Plan. It’s a healthcare plan designed for employees of the City of New York, as well as non-Medicare eligible retirees.

Below, you can learn more about the Gold Plan, including eligibility, plan coverage, potential costs and more.

The Gold Plan is available for all City of New York employees, including qualified domestic partners and eligible dependents. Retirees who aren’t eligible for Medicare are also eligible for the Gold Plan.

The Gold Plan covers a variety of things, from preventive visits and immunizations, to hospitalization, lab tests and pregnancy care. In-network benefits include:

• Primary care, specialist visits, preventive care/screening/immunizations
• Diagnostic tests and imaging
• Outpatient surgery
• Emergency and urgent care
• Hospital stays
• Inpatient and outpatient mental health care
• 40 home health care visits per plan year
• Maternity care
• Habilitation and rehabilitation services
• Skilled nursing care
• Durable medical equipment
• Hospice services

Other services that may be covered include:

• Bariatric surgery
• Chiropractic care
• Hearing aids
• Infertility treatment
• Weight loss programs
• Transportation to medical appointments

This list is not complete, and some limitations may apply. You can consult plan documents for more specific coverage information.

MetroPlusHealth Gold members can receive partial reimbursements for wellness apps, exercise facilities, and transportation to doctor visits. Exercise facilities must have equipment and programs that promote cardiovascular wellness to qualify – this does not include country clubs, tennis clubs, weight loss clinics or spas. All varieties of transportation, including taxis, car services and rideshare apps, are eligible for reimbursement up to $15 each for four trips.

Wellness apps eligible for reimbursement include:

• Calm
• CitiBike
• HeadSpace
• Lifesum
• MyFitnessPal
• Noom
• Peleton
• Sleep Cycle
• Strava
• WW