Know Your Benefits
Marketplace Benefits
The NY State of Health is a health plan marketplace where individuals, families, and small businesses can browse and purchase health insurance online. MetroPlus Health Plan, the plan of choice for half a million New Yorkers, offers Qualified Health Plans- or QHPs – through The NY State of Health Marketplace at an affordable rate for you and your family.
Learn more about the benefits available to you through our Marketplace plans below.
Essential Health Benefits
- Outpatient care – the kind you get without being admitted to a hospital
- Trips to the emergency room
- Treatment in the hospital for inpatient care
- Care before and after your baby is born
- Mental health and substance use disorder services: This includes behavioral health treatment, counseling, and psychotherapy
- Your prescription drugs
- Services and devices to help you recover if you are injured, or have a disability or chronic condition. This includes physical and occupational therapy, speech-language pathology, psychiatric rehabilitation, and more.
- Your lab tests
- Preventive services including counseling, screenings, and vaccines to keep you healthy and care for managing a chronic disease.
- Pediatric services: This includes dental care and vision care for kids
Find it fast
*Find A Dentist: Participating dental providers for all our health plans, excluding MetroPlusHealth Gold and GoldCare
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.
GREAT NEWS: STARTING JANUARY 1, 2023, METROPLUSHEALTH MEMBERS WILL RECEIVE THEIR DENTAL BENEFITS FROM DENTAQUEST.
Recently, we sent you an announcement along with your new ID Card about our new partnership with DentaQuest, a dental vendor. Starting January 1, 2023, you can begin to use your new ID Card for all your health care needs, including dental services with DentaQuest. Remember to bring your new ID card when you visit your dentist.
Your oral health is important to us. Partnering with DentaQuest, we are able to bring their experience and passion for improving oral health care to you. Their dental network is 65% larger than what we have been offering, with more dentists and specialists available than before. Learn more about your new dental benefit here.
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
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.
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- Explore PlansMetroPlusHealth has offered low-cost, quality health care for New Yorkers for more than 35 years. Find a plan that's right for you.
- Individual + Family Plans
- NYC Employee Plans
- Medicare and Dual-Eligible Plans
- Special Needs and Long Term Care
PLAN SHORTCUTS
Explore Plans
MetroPlusHealth has offered low-cost, quality health care for New Yorkers for more than 35 years. Find a plan that's right for you.PLAN SHORTCUTS
- For MembersMetroPlusHealth members can access the Member Portal, find doctors, specialists, and pharmacies, and view member benefits.
MEMBER SHORTCUTS
For Members
MetroPlusHealth members can access the Member Portal, find doctors, specialists, and pharmacies, and view member benefits.MEMBER SHORTCUTS
- In Your CommunityFind MetroPlusHealth offices, events, and local family care sites right near you.
In Your Community
Find MetroPlusHealth offices, events, and local family care sites right near you. - Help With InsuranceGet inspired on our Blog, find answers to your questions in our FAQs, and explore our health library.
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Help With Insurance
Get inspired on our Blog, find answers to your questions in our FAQs, and explore our health library.INSURANCE SHORTCUTS
- About UsMeet our leadership, join our team, or get in touch with MetroPlusHealth.
ABOUT SHORTCUTS
About Us
Meet our leadership, join our team, or get in touch with MetroPlusHealth.ABOUT SHORTCUTS
- Providers ResourcesWe’re committed to being the best possible partner to our 34,000+ providers like you. We’re here to help with anything you need.
Providers Resources
We’re committed to being the best possible partner to our 34,000+ providers like you. We’re here to help with anything you need.Login- Authorization Grids
- Provider Training
- Forms, Manual and Policies
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- Behavioral Health
- News
- ClaimsWe’ve made claims easy so you can quickly get back to caring for your patients.
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Claims
We’ve made claims easy so you can quickly get back to caring for your patients.CLAIMS SHORTCUTS
- Our NetworkWe partner with over 40 hospitals, 110 urgent care centers, 400 pharmacies, and 34,000+ providers like you to give patients everything they need.
Our Network
We partner with over 40 hospitals, 110 urgent care centers, 400 pharmacies, and 34,000+ providers like you to give patients everything they need. - Join Our NetworkHelp us keep our 713,000+ members healthy. We’re all about people, not profit.
Join Our Network
Help us keep our 713,000+ members healthy. We’re all about people, not profit.
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