Have questions?

MetroPlusHealth offers a variety of high-quality, affordable health insurance plans that fit your needs and budget.

MetroPlusHealth offers the following plans:

Essential Plans: These plans are designed to meet the minimum requirements of the Affordable Care Act (ACA). They offer coverage for essential health benefits, such as preventative care, prescription drugs, and emergency care.

Marketplace Plans: These plans are available through the Health Insurance Marketplace. They offer a variety of coverage options, including different levels of premiums, deductibles, and copays.

Medicaid Managed Care Plans:  These plans are available to people who are eligible for Medicaid. They offer a comprehensive set of benefits, including coverage for doctor visits, prescription drugs, and long-term care.

Medicare Plans: These plans are available to people who are 65 years of age or older. They offer a variety of coverage options, including different levels of premiums, deductibles, and copays.

Child Health Plus: This plan is available to children under 19 who are not eligible for Medicaid. It offers coverage for essential health benefits, such as preventative care, prescription drugs, and emergency care.

Enhanced (HARP) Plan: This plan is available to Medicaid recipients 21 or older who need additional resources for behavioral health. It offers coverage for behavioral health services, such as therapy and medication.

Selecting the right plan can be overwhelming, but affordability, convenient access to care, and excellent customer service are all things to consider as you select your plan.

Everyone is different, but if a plan has affordable premiums, a wide network of providers (including hospitals, doctors, and specialists), excellent customer service, convenient access to care, and programs to help you earn rewards and points, it might be the right plan for you.

MetroPlusHealth offers affordable premiums, over 34,000 providers, excellent customer service professionals, and programs that reward you for taking care of yourhealth.

You can enroll in the MetroPlusHealth Essential Plan by phone, or in person.

Wherever you live in New York City, our Marketplace Facilitated Enrollers (FEs), navigators, brokers, and agents are available to help you complete your application in the NY State of Health Marketplace. Call us at 855-809-4073, TTY: 711, Monday through Friday, 8AM – 8PM, and Saturday, 9AM – 5PM to make an appointment.

You should receive your welcome kit and ID mailed within the first 15 days of membership.

If you have not received your welcome kit and ID card within the first 15 days of membership, you can contact MetroPlusHealth customer service at 855-809-4073

It all depends!

If you are enrolled in the MetroPlusHealth Essential Plan, your coverage will last for 12 months. You can renew your coverage for an additional 12 months if you continue to meet the eligibility requirements.

Creating an account on the member portal is quick and easy. It is the best way to manage all of your plan benefits.

• Go to “Metroplus.org”
• Click on the “For members” tab
• Click on the link that says “Member Portal”
• Click “Create an Account”
• Follow the prompts to create an account, and access your plan benefits, ID card, and more.

If you already have an account, accessing the Member Portal is quick and easy.

MetroPlusHealth does have a mobile app. Downloading the app is a quick way to manage your health plan and benefits while you are on the move.

Want quick access to your plan benefits?

• Download the MetroPlusHealth mobile app from Google Play (Android) or App Store
  (iOS).
• Search for “MetroPlusHealth Member”
• Get, or select Download
• Open the app
• Create an account to log on for the first time, or sign in with your userID and password
  you have already created.
• Begin accessing your plan information.

You would use the same userID and password.

The Essential Plan benefit highlights include $0 preventative care. Urgent and emergent care are also plan benefits.

With no monthly premiums and no cost for dental and vision, our Essential Plans offer all of the essential benefits you need: preventative care, emergency care, prescription drugs, mental health, and more.

Plus, there’s no deductible, so the plan starts paying for your health care right away.

You get free preventative care like routine doctor exams and screenings to keep you healthy

The Essential Plan offers a variety of services to help keep you on a path to feeling your best.

The Essential Plan offers preventative Services to keep you healthy, counseling, screenings, vaccines, chronic disease management, mental health and substance use disorder services, behavioral health treatment, counseling, psychotherapy, lab tests, outpatient care, trips to the emergency room, treatment in the hospital for inpatient care, prescription drugs, services and devices to help you recover if you are injured, or have a disability or chronic condition, physical and occupational therapy, speech-
language pathology, psychiatric rehabilitation.

You can obtain care from a Primary Care Physician, via a Virtual Visit, from an Urgent Care Center, or in extreme situations, from an Emergency Room.

You can obtain care via the following methods:

Primary Care Physician (PCP):
Your primary care physician should be your main source of contact. See your PCP for your yearly wellness visit, vaccinations and referrals to specialists. Your wellness visit, and vaccinations cost $0.
Find a PCP

Virtual Visit:
Our program offers a choice to get care from board certified doctors. Use your phone or video chat on your computer. It is available 24/7 and has a $0 copay. Use for non-emergency issues such as allergy, sore throat, earache, nausea, vomiting and after-hours care.
Access virtual visit now

Urgent Care:
Also known as a walk-in-clinic. Use for nonserious medical issues when your doctor is not available. Visit an Urgent Care for colds/flu, fevers, cuts/sprains/strains, sore throats.
Find an Urgent Care

Emergency Room:
If you feel you are experiencing serious medical situations. Visit an Emergency Room if you are experiencing a heart attack, stroke, difficulty breathing, broken bones, severe allergic reaction or a sudden change in your health that is causing you concern.

Yes.

The MetroPlusHealth Member Rewards program is designed to encourage members to live healthier lives.

To participate in MetroPlusHealth Rewards, you must first enroll in the program.

You can do this by visiting the MetroPlusHealth website or by calling MetroPlusHealth at 855-809-4073