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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

Monthly Premium

$0

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

Deductible

$0

$0 24/7 Telehealth Yes
Adult Dental & Vision Yes
Annual Checkup

$0

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

Deductible

$0

Adult Dental & Vision No
Annual Checkup

$0

Fitness (Gym) Reimbursement No
Hearing Yes
Pediatric Dental & Vision Yes
Prepackaged Medications Yes
Prescription Drug Coverage Yes
Weight Loss Program Reimbursement No

Gold Plan

Monthly Premium

$0

Eligibility

Employees of the city of New York (as well as certain retireees)
and their spouse and children

Deductible

$0

$0 24/7 Telehealth Yes
Adult Dental & Vision No
Annual Checkup

$0

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.

Deductible

$0 or $257**

Adult Dental & Vision Yes
Annual Checkup

$0

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

Monthly Premium

$92

Eligibility

Must have Medicare Part A, be enrolled in Medicare Part B, and live in New York City.

Deductible

$0

Adult Dental & Vision Yes
Annual Checkup

$0

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.

Deductible

$0

Adult Dental & Vision Yes
Annual Checkup

$0

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
Annual Checkup

$0

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
Annual Checkup

$0

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
Annual Checkup

$0

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
Annual Checkup

$0

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
Annual Checkup

$0

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

Deductible

$0

Adult Dental & Vision No
Annual Checkup

$0

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)

Monthly Premium

$0

Eligibility

For Medicaid recipients with certain disabilities that requires long-term care, in home or in a facility

Deductible

$0

$0 24/7 Telehealth Yes
Adult Dental & Vision Yes
Annual Checkup

$0

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

Monthly Premium

$0

Eligibility
Deductible

$0

Adult Dental & Vision No
Annual Checkup

$0

Fitness (Gym) Reimbursement No
Hearing Yes
Pediatric Dental & Vision Yes
Prepackaged Medications Yes
Prescription Drug Coverage No
Weight Loss Program Reimbursement No

Enhanced (HARP)

Monthly Premium

$0

Eligibility

Medicaid recipients 21 and older who need additional resources to help with mental health or substance abuse issues

Eligibility

year round

Deductible

$0

$0 24/7 Telehealth Yes
Adult Dental & Vision Yes
Annual Checkup

$0

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

Monthly Premium

$0

Eligibility

For Medicaid eligible New Yorkers with HIV/AIDS and their children, certain other groups (homeless, transgender) also are eligible

Deductible

$0

Adult Dental & Vision Yes
Annual Checkup

$0

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
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