Compare Plans Find the best plan for you.
MetroPlusHealth plans offer access to 34,000 providers, 40 hospitals, and 110 urgent care centers. Find a plan that’s right for you.
Essential Plan Eligibility New York city residents lawfully present in the U.S. 19-64 years old not eligible for Medicaid or employer coverage and with income within the guidelines
$0 24/7 Telehealth Yes
Adult Dental & Vision Yes
Fitness (Gym) Reimbursement $200 every 6 mo. for member
Hearing Yes
Pediatric Dental & Vision No
Prepackaged Medications Yes
Prescription Drug Coverage Yes
Weight Loss Program Reimbursement No
Child Health Plus Monthly Premium $0-$60 per month,
depending on income
Eligibility Children under age 19 not covered by their parents health insurance plan and not eligible for other coverage such as Medicaid
Adult Dental & Vision No
Fitness (Gym) Reimbursement No
Hearing Yes
Pediatric Dental & Vision Yes
Prepackaged Medications Yes
Prescription Drug Coverage Yes
Weight Loss Program Reimbursement No
Gold Plan Eligibility Employees of the city of New York (as well as certain retireees) and their spouse and children
$0 24/7 Telehealth Yes
Adult Dental & Vision No
Fitness (Gym) Reimbursement Up to $700 every 6 months
Hearing No
Pediatric Dental & Vision Yes
Prepackaged Medications Yes
Prescription Drug Coverage No
Weight Loss Program Reimbursement Yes
Medicare Advantage Plans Monthly Premium $0 or $71.20**
Eligibility 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.
Adult Dental & Vision Yes
Fitness (Gym) Reimbursement $250 every 6 months
Hearing Yes
Pediatric Dental & Vision No
Prepackaged Medications Yes
Prescription Drug Coverage Yes
Weight Loss Program Reimbursement No
Medicare Platinum Plan Eligibility Must have Medicare Part A, be enrolled in Medicare Part B, and live in New York City.
Adult Dental & Vision Yes
Fitness (Gym) Reimbursement No
Hearing Yes
Medicare UltraCare Monthly Premium $0 with basic plan
Eligibility Have Medicare Part A, be enrolled in Medicare Part B, eligible for Medicaid Need at least one Community Based Long-Term Care Services for more than 120 days, and live in New York City.
Adult Dental & Vision Yes
Fitness (Gym) Reimbursement $250 every 6 months
Hearing Yes
Pediatric Dental & Vision No
Prepackaged Medications Yes
Prescription Drug Coverage Yes
Weight Loss Program Reimbursement No
GoldCare Plan Monthly Premium $0 individual/up to $90 per month for a family
Eligibility NYC Large Employer groups and their spouse and children
Adult Dental & Vision Yes
Pediatric Dental & Vision Yes
Prepackaged Medications Yes
Prescription Drug Coverage Yes
BronzePlus Plan Monthly Premium $786 per month (single)
Eligibility New York city residents lawfully present in the U.S. 19-64 years old not eligible for Medicaid or employer coverage and with income too high for EP
Deductible $3,800/individual or $7,600/family
Adult Dental & Vision No
Doctors & Specialists Yes
Fitness (Gym) Reimbursement Up to $300 every 6 months
Hearing Yes
Pediatric Dental & Vision Yes
Prepackaged Medications Yes
Prescription Drug Coverage Yes
Weight Loss Program Reimbursement No
SilverPlus Plan Monthly Premium $995.38 per month (single)
Eligibility New York city residents lawfully present in the U.S. 19-64 years old not eligible for Medicaid or employer coverage and with income too high for EP
Deductible $2,100/individual or $4,200/family
Adult Dental & Vision No
Fitness (Gym) Reimbursement Up to $300 every 6 months
Hearing Yes
Pediatric Dental & Vision Yes
Prepackaged Medications Yes
Prescription Drug Coverage Yes
Weight Loss Program Reimbursement No
GoldPrime Plan Monthly Premium $1231.24 per month (single)
Eligibility New York city residents lawfully present in the U.S. 19-64 years old not eligible for Medicaid or employer coverage and with income too high for EP
Deductible $675/individual or $1,350/family
Adult Dental & Vision No
Fitness (Gym) Reimbursement Up to $300 every 6 months
Hearing Yes
Pediatric Dental & Vision Yes
Prepackaged Medications Yes
Prescription Drug Coverage Yes
Weight Loss Program Reimbursement No
GoldPlus Plan Monthly Premium $1212.70 per month (single)
Eligibility New York city residents lawfully present in the U.S. 19-64 years old not eligible for Medicaid or employer coverage and with income too high for EP
Deductible $600/individual or $1,200/family
Adult Dental & Vision No
Fitness (Gym) Reimbursement Up to $300 every 6 months
Hearing Yes
Pediatric Dental & Vision Yes
Prepackaged Medications Yes
Prescription Drug Coverage Yes
Weight Loss Program Reimbursement No
PlatinumPlus Plan Monthly Premium $1454.72 per month (single)
Eligibility New York city residents lawfully present in the U.S. 19-64 years old not eligible for Medicaid or employer coverage and with income too high for EP
Adult Dental & Vision No
Fitness (Gym) Reimbursement Up to $300 every 6 months
Hearing Yes
Pediatric Dental & Vision Yes
Prepackaged Medications Yes
Prescription Drug Coverage Yes
Weight Loss Program Reimbursement No
Managed Long Term Care (MLTC) Eligibility For Medicaid recipients with certain disabilities that requires long-term care, in home or in a facility
$0 24/7 Telehealth Yes
Adult Dental & Vision Yes
Fitness (Gym) Reimbursement No
Hearing Yes
Pediatric Dental & Vision Yes
Prepackaged Medications Yes
Prescription Drug Coverage Yes
Weight Loss Program Reimbursement No
Medicaid Managed Plan Adult Dental & Vision No
Fitness (Gym) Reimbursement No
Hearing Yes
Pediatric Dental & Vision Yes
Prepackaged Medications Yes
Prescription Drug Coverage No
Weight Loss Program Reimbursement No
Enhanced (HARP) Eligibility Medicaid recipients 21 and older who need additional resources to help with mental health or substance abuse issues
$0 24/7 Telehealth Yes
Adult Dental & Vision Yes
Fitness (Gym) Reimbursement No
Hearing Yes
Pediatric Dental & Vision Yes
Prepackaged Medications Yes
Prescription Drug Coverage Yes
Weight Loss Program Reimbursement No
Partnership In Care (PIC) HIV - SNP Eligibility For Medicaid eligible New Yorkers with HIV/AIDS and their children, certain other groups (homeless, transgender) also are eligible
Adult Dental & Vision Yes
Fitness (Gym) Reimbursement No
Hearing Yes
Pediatric Dental & Vision Yes
Prepackaged Medications Yes
Prescription Drug Coverage Yes
Weight Loss Program Reimbursement No
last updated: June 25, 2025