SilverPlus 2025
The MetroPlusHealth Marketplace SilverPlus Plan is the perfect balance of affordability and comprehensive care for individuals and families in New York. With this plan, members gain access to preventive care, primary and specialty doctor visits, prescription drugs, hospital services, and more—all at a manageable cost. As one of the most popular Marketplace health insurance plans, the SilverPlus Plan ensures that you receive reliable healthcare coverage while keeping monthly premiums and out-of-pocket expenses affordable.
MetroPlusHealth offers a variety of different SilverPlus plans. Each plan adds additional levels of customization to fit your needs.
The plan has an individual deductible of $0 – $2,100 and a max out of pocket of $1,075 – $9,200 (depending on eligibility). The plan has a family deductible of $0 – $4,200 and a max out of pocket of $2,000 – $18,400 (depending on eligibility).
This plan also has an American Indian / Alaska Native plan with a $0 deductible and $0 max out of pocket for those that qualify.
You can enroll with us in a MetroPlusHealth Marketplace plan directly by clicking here (“Off Exchange”) or through the NY State of Health (NYSOH), the Official Health Plan Marketplace (“Exchange”).
Interested in one? Think you might be eligible for a NYSOH premium subsidy? Call us at 1-855-809-4073 or contact us here. One of our representatives will contact you to review your plan options.
2025 SilverPlus*
* 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
2025 SilverPlus*
* These charts are brief descriptions of benefits for plan.
** Prescription Drug: Generic / Formulary Brand / Non-Formulary Brand
◊ Deductible must be met first before cost sharing begins. Family cost is multiplied by (2)
□ FPL = Federal Poverty Level
2025 SilverPlus*
* These charts are brief descriptions of benefits for plan.
** Prescription Drug: Generic / Formulary Brand / Non-Formulary Brand
◊ Deductible must be met first before cost sharing begins. Family cost is multiplied by (2).
□ FPL = Federal Poverty Level
Cost Sharing Reductions (CSR) Plans are available to people who have incomes between 100% and 250% of the Federal Poverty Level (FPL).
2022 Poverty Guidelines for 48 States and the District of Columbia (Excludes Alaska and Hawaii)
How do I enroll?
Enrolling is hassle-free and easy as one, two, three! All you need is your:
- Proof of residency in the 5 boroughs of NYC
- Proof of immigration status
- Proof of relationship status for any dependents
Enroll online today. Or call us at 855-809-4073. A representative will contact you shortly to help you enroll.
Representative was very professional and helpful, showed empathy for my well being with no attitude …. Thank you….. 😊 👍👍
Plan Materials
Certificate of Coverage
(includes Contract, Schedule of Benefits, Summary of Benefits and Coverages)
"Off Exchange"
"Exchange"
Summary of Benefits
"Off Exchange"
"Exchange"
Additional Member Resources
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
