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PlatinumPlus 2025

Why choose MetroPlusHealth?

Quality Care When and Where You Need It

Access Top-Rated Healthcare Providers

MetroPlusHealth Essential Plan connects you with NYC’s finest healthcare network:

  • 34,000+ top doctors across the city
  • 40+ premiere hospitals including Mount Sinai, NYU Langone, and NY Health + Hospitals
  • 110+ urgent care locations including convenient CityMD sites

Perfect for families: Our health insurance for families covers everyone’s needs with one simple plan.
Care on your schedule: Access online doctor visits and virtual urgent care from home, work, or anywhere with our telemedicine health insurance coverage.

Why Choose a New York-Only Health Care Plan?

Is a not-for-profit organization (prioritizing you, not profits)
Was created by New Yorkers, for New Yorkers
Proudly provides customer service from real people who live in NYC
Offers you 34,000+ providers across all five boroughs

National Health Care Chains

Prioritize their bottom line profits (not you)
Are based outside of NYC
Provide impersonal customer service
Offer uncertain provider networks

PlatinumPlus 2025 Plans

The Ultimate in Worry-Free Healthcare

MetroPlusHealth offers several PlatinumPlus options, each customized to fit your specific healthcare needs.

Zero Deductible, Maximum Peace of Mind

PlatinumPlus Plan Benefits:

  • Individual deductible: $0
  • Individual maximum out-of-pocket: $2,000
  • Family deductible: $0
  • Family maximum out-of-pocket: $4,000

Special Coverage for American Indian/Alaska Native Members

Our dedicated AI/AN plan offers additional savings:

  • $0 deductible
  • $0 maximum out-of-pocket costs
  • Complete coverage from day one

Two Simple Ways to Join

Enrolling is easy:

  1. Direct enrollment through MetroPlusHealth (“Off Exchange”)
  2. NY State of Health Marketplace (“Exchange”)

Explore our MetroPlusHealth Platinum Plus plans below and find your perfect match!

Questions about eligibility? You might qualify for premium subsidies. Call us at1-855-809-4073 or contact us here, and our friendly team will guide you through your options.

2025 PlatinumPlus*

P1

Standard
Premium$1,454.72
Deductible$0
Max Out of Pocket$2,000
PCP$15
Specialist$35
Prescription Drugs**$10 / $30 / $60
Adult Dental / VisionNo
Pediatric Dental / VisionYes
Mail Order RXYes
Exercise Facility ReimbursementYes

P2

Non-Standard
Premium$1,502.53
Deductible$0
Max Out of Pocket$1,650
PCP$10
Specialist$20
Prescription Drugs**$0 / $20 / $50
Adult Dental / VisionYes
Pediatric Dental / VisionYes
Mail Order RXYes
Exercise Facility ReimbursementYes

P3

Child-Only
Premium$599.64
Deductible$0
Max Out of Pocket$2,000
Max Out of Pocket$2,000
PCP$15
Specialist$35
Prescription Drugs**$10 / $30 / $60
Adult Dental / VisionNo
Pediatric Dental / VisionYes
Mail Order RXYes
Exercise Facility ReimbursementYes

P5 (ADULT)

AI / AN Standard
Premium$1,454.72
Deductible$0
Max Out of Pocket$0
PCP0%
Specialist0%
Prescription Drugs**0%
Adult Dental / VisionNo
Pediatric Dental / VisionYes
Mail Order RXYes
Exercise Facility ReimbursementYes

P3-4 (CHILD)

AI / AN-Standard
Premium$599.64
Deductible$0
Max Out of Pocket$0
PCP0%
Specialist0%
Prescription Drugs**0%
Adult Dental / VisionNo
Pediatric Dental / VisionYes
Mail Order RXYes
Exercise Facility ReimbursementYes

P6

AI / AN-Non-Standard
Premium$1,502.53
Deductible$0
Max Out of Pocket$0
PCP0%
Specialist0%
Prescription Drugs**0%
Adult Dental / VisionYes
Pediatric Dental / VisionYes
Mail Order RXYes
Exercise Facility ReimbursementYes

* These charts are brief descriptions of benefits for the plan.

** Prescription Drug: Generic / Formulary Brand / Non-Formulary Brand

◊ Deductible must be met first before cost sharing begins. Family cost is multiplied by (2).

□ AI / AN – American Indian / Alaskan Native

Premiums listed are example base rates for individuals. Rates may differ based according to family size, income level, and eligibility for tax credits. In accordance with Section 1303 of the Patient Protection and Affordable Care Act, at least $1.00 of the total premium amount owed per enrollee per month is a payment for coverage of non-Hyde abortion services.

Find out if you’re eligible today

We are available 6 days a week

Monday – Friday | 8am – 6pm (ET), Saturday | 9am – 5pm (ET)

How to enroll

Signing up is simple! Here’s what you need:

  • Proof of residency (Must live in one of NYC’s 5 boroughs)
  • Immigration documents (If applicable)
  • Proof of relationship status (For health insurance for dependents in NY)

Need help? Call 855-809-4073 and a friendly representative will guide you through the process.

Ready to get covered?

A young family walks their two dogs while the mother holds a small child

Personally I’ve always had and still have very great experiences with MetroPlusHealth, I would recommend it to anyone who is looking for the best health insurance services. Thank you MPH for always taking great care of me and mines.

Michaelle J.
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Members and providers accessing MetroPlusHealth's online resource library
MetroPlusHealth Virtual Visit

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.

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

Explore all MetroPlusHealth Plans

last updated: June 25, 2025
MetroPlusHealth
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